I prayed for this Child, and the Lord granted my request. In return I am giving him to the Lord.

He will be
dedicated to the Lord for his whole life.

This Certifies
That

____________________________________________________________

Born on __________________, ______________________

In ________________________,___________________________________

Was

Dedicated to God
In the Name of the Father, of the Son and of the Holy Spirit

Upon the Request of _______________________Loving parents

________________________________and ____________________________________

Who vow before the Lord to submit this Precious Child to God’s will and to raise

___________________according to God’s Word and Commandments;

In the State of ______________________, the City of ____________________

On the ___________________day of___________________________

In the year of our Lord, _____________________________

Mother_________________________Father________________________________

Officiated By: ___________________________