Phone number *
Phone type Mobile Home Work Other
Birthplace *
Please provide City and Province.
Hospital *
Please provide City and Province. If the child was a home birth please state "at home"
Church Currently Attending *
Please provide name of church, City and Province
Signature of Father *
Please click that you confirm that all information is accurate.
Select… Yes, all information that has been provided is accurate
Signature of Mother *
Please click that you confirm that all information is accurate.
Select… Yes, all information that has been provided is accurate
Family Verse
Please choose a verse from the Bible you would like to use during the service.
Provide Pictures
Please email up to 5 pictures to shannon@gw.church
Do you acknowledge your child as a gift from God? *
Select… Yes No
Do you desire to live a Godly life before your child so that he or she will have an example to follow? *
Select… Yes No
Do you commit yourself to give your child opportunity to hear the gospel so that he or she might be able to have a personal relationship with Christ? *
Select… Yes No
Do you commit yourself to raise your child in the instruction of the Lord? *
Select… Yes No
Do you receive this child with gratitude, as God’s gift to you and your family? *
Select… Yes No
Do you commit to each other as parents, creating a stable environment in which your child can mature? *
Select… Yes No
Do you desire to be parents of personal faith, recognizing your children are more likely to follow God’s path by the model they first observed in you? *
Select… Yes No
Do you desire to lead a faith filled home, that honours God in all your relationships and in the choices you make? *
Select… Yes No
Do you desire to be parents with patience? *
Recognizing that with your inherent strengths and weaknesses, your desire to shape your child is a loving act that will require time, prayer, and God, in order to produce in your children what He and you hope for?
Select… Yes No
Have you accepted Jesus Christ as your personal Lord and Saviour? *
Select… Yes No
How long have you been attending Gateway Church *
Select… Less then a year 1 to 3 years 3 to 5 years Over 5 years
What does the Bible teach about parenting? *
Please provide a favourite scripture for reference
What can we do as a church to equip you in your role as spiritual parent? *
Have you accepted Jesus Christ as your personal Lord and Saviour? *
Select… Yes No
How long have you been attending Gateway Church *
Select… Less then a year 1 to 3 years 3 to 5 years Over 5 years
What does the Bible teach about parenting? *
Please provide a favourite scripture for reference
What can we do as a church to equip you in your role as spiritual parent? *
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