Membership & Discipleship Class - Thursday, January 30 - 6:30 p.m.

Name

Second Attendee or No Name if not applicable

Phone

This address will receive a confirmation email

Childcare Needs

Yes No

If childcare is need, list children's Names and Date of Birth

Would you like a pizza and salad dinner?

Yes No Contact me, please

Description

Please fill out this form and click submit.