Family DedicationApplication & Information Packet

Our next Family Dedication is Sunday, April 9, 2017

Completed application must be e-mailed to troberts@tbclife.net or brought to the Preschool office by Sunday, March 26, 2017. If you have questions, email Traci Roberts at troberts@tbclife.net or call 601-450-3068.

Please note: TBC membership is required to participate in Family Dedication. We will follow-up with you to either discuss your application further or schedule an appointment.

Is this your first time to participate in Dedication at TBC? YES NO

1. Adult participants and relation to child (as you would like us to announce)

Name __________________________________________Relationship _________________________ First Last

Name __________________________________________Relationship _________________________ First Last

Does the child reside with both participants? _____YES _____NO

If no, please explain: _________________________________________________________________

2. Mailing address: ___________________________________________________________________

Email address: ________________________________________________________________________

Cell phone: _____________________________________________________________________________

3. Relationship status of adult participants:

______ child’s parents married to each other______ a parent of the child married to another______ child’s parents separated/divorced but desiring to commit together______ child’s parent committing alone due to unbelieving spouse______ single parent committing alone______ single parents, unmarried, living separately, committing together______ single parent(s), unmarried, living together or with another, committing together or

separately______ boyfriend, girlfriend, or fiancé of a participating adult (Please specify which:

___________________________________________________)______ other: explain _______________________________________________________________

4. Are you a current member of TBC? ________YES ______NOIf no, what church are you a member of? _______________________________________

5. List the current participation at TBC of each adult:Participation ______________________________ Frequency ________________________ Worship, Bible Fellowship, etc.Participation ______________________________ Frequency ________________________ Worship, Bible Fellowship, etc.

6. Child(ren) being dedicated:

Name ____________________________________________________________ DOB _____________ First Middle Last Called by

Name ____________________________________________________________ DOB _____________ First Middle Last Called by

Name ____________________________________________________________ DOB _____________First Middle Last Called by

7. List any siblings of the child(ren) (first names only needed)

_______________________________________ ______________________________________

_______________________________________ ______________________________________

8. The Preschool Ministry has permission to use my child’s picture on the church website, Facebook, or in workshops/brochures representing TBC. ________YES ________NO

9. Do you have any special info or a story you’d like to share about your child?___________________________________________________________________________________________

10. Complete the attached testimony form for each participating adult and return it with this paperwork packet.

11. See the sample Commitment form (attached). The actual form will be filled out by the parents during the “Faith at Home” luncheon/class and then returned to you on the day of dedication. All paperwork is due back to the Preschool office for processing. Once paperwork has been processed, you will be contacted regarding your participation in the “Faith at Home” luncheon/class and dedication.

My Personal TestimonyPlease briefly describe your salvation experience:

My life before becoming a Christian:

_______________________________________________________________________________________________________________________________________________________________________________________How I realized my need for Christ:

_______________________________________________________________________________________________________________________________________________________________________________________Why I accepted Christ as my Lord and Savior:

_______________________________________________________________________________________________________________________________________________________________________________________When and how the decision of following Christ was made:

_______________________________________________________________________________________________________________________________________________________________________________________Specific ways Christ has changed my life:

________________________________________________________________________________________________________________________________________________________________________

Have you been baptized by immersion since your salvation experience? YES______ NO______

Signature _________________________________________________ Date _______________________

This is a rough draft for you to keep, You will receive a Commitment Certificate on the day of Dedication.

Commitment Covenant

Last Name(s) ___________________________________ First Name __________________________

Child’s Name ___________________________________________________________________________

As a covenant between myself and God, myself and my child, and myself and my church, I commit to:

________ love this child unconditionally

________ provide for this child to the best of my ability

________ live a moral, God-honoring lifestyle in my home and outside my home

________ pray for this child regularly

________ teach this child principles of God’s Word, modeling them in my own life

________ guide this child to come to know Christ as his/her personal Savior

________ keep this child involved in a Bible-believing church

Personal words of commitment to this child:

Signed _________________________________________________ Date ___________________________

Signed _________________________________________________ Date ___________________________