Connect Women Reservations
Connect Women Reservations
First Name  * 
Last Name  * 
Will you need child care? (Ages birth - 5th grade only)  * 
If yes, how many children will need care?
Please list each child ON SEPARATE LINES with names, ages and allergies (if any)
What is the cell phone number in case of emergency?
Are you affiliated with another local church?
If yes, which church are you affiliated with?
Your Email Address  * 
Total $
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