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Item Number
200
Price
$19.95
Quantity:
Child's First Name
Child's Middle Name
(Optional)
Child's Last Name
Sex
(Male or Female)
Home Town
(include province)
SAMPLE DEDICATION
The 3-line dedication appears on the title page, for example:
#1 With Lots of Love!
#2 Mommy and Daddy
#3 November 9, 2005
Insert YOUR Dedication Line #1 in this space:
Dedication Line #2
Dedication Line #3
PLEASE NOTE:
A minimum of 2 friends or relatives are necessary for the story line.
Friend or Relative #1
Friend or Relative #2
Friend or Relative #3
Date of Birth
(specifiy month/day/year)
Time of Birth
(specify hour/minutes - am/pm)
Name of Hospital
Length
(specify inches or centimetres)
Weight
(specify pounds or kilograms)
Delivered by
Mother's First Name
Father's First Name
Parents
This book is from -
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