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Today's Date:(*)
Please complete field.

Contact Person(*)
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Contact Email(*)
Please let us know your email address.

Phone(*)
Please enter your phone number. (123-456-7890)

Please indicate your first and second choices for your baby blessing
Times available are either 8am or 11am.
1st Choice date and time(*)
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Choose either 8am or 11am

2nd Choice date and time(*)
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Choose either 8am or 11am

Childs Name(*)
Please enter your childs name.

Gender
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Birthdate(*)
Please enter birthdate mm/dd/yyyy

mm/dd/yyyy

Name of Father

Address-City-State-Zip

Phone

Email
Please let us know your email address.

Name of Mother

Address-City-State-Zip

Phone

Email
Please let us know your email address.

Name of Godparents

Name of Grandparents

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