Immaculate Virgin Mary Mother of God and Mother of the Church,  you are also our Mother of Perpetual Help. With hearts full of love for you, we consecrate ourselves to you Immaculate Heart, so that we may be your devoted children. Obtain for us true sorrow for sins and fidelity to the promises of our Baptism.
 We consecrate our minds and hearts to you that we may always do the will of our heavenly Father. We consecrate our lives to you that we may love God better and live not for ourselves but for Christ your Son and that we may see Him and serve Him in others.
 By this humble act of consecration dear Mother of Perpetual Help, we pledge to model our lives on you,  the perfect Christian,  so that consecrated to you in life and in death  we may belong to your Divine Son for all eternity. Amen.

FROM: Shrine of Our Mother of Perpetual Help, Church of St. John the Baptist – Capuchin Friars, 210 West 31st St. New York, NY 10001
AND
http://www.rveritas-asia.org/prayers/perpetual.htm

United with the members of your confraternity here and throughout the world, we consecrate ourselves to your service. We promise to renew this dedication once a month and frequently to receive the sacraments. We beg you to obtain for us the grace to imitate your great servant, St. Alphonsus, in his love for you and your Son.
http://www.liguori.org/redemptorists/saints/omph/archconfrat.htm  AND http://www.premier.net/~avemarie/Mother_of_Perpetual_Help2.htm AND http://users.erols.com/saintpat/perphelp.htm

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