MOTHER'S INFORMATION:
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Are you a member of The Upper Room Of Prayer?*

Have you been born again?*
YesNo


BABY'S INFORMATION:

Please upload a photo of your baby:


FATHER'S INFORMATioN:

Are you a member of The Upper Room Of Prayer? *
I am a member.I am a regular attender.No, I am not a member.

Have you been born again?*
YesNo