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ABOUT US
What We Believe
What We Value
Where We've Been
Where We're Headed
Our Team
Our Location
Contact Us
WHAT'S HAPPENING
GET CONNECTED
Worship With Us
Church Directory
Small Groups
Discipleship
Youth
Kids
Young Adult
Other Ministries
MAKE A DIFFERENCE
Give
Serve
Manna
Global
GIVE
ABOUT US
What We Believe
What We Value
Where We've Been
Where We're Headed
Our Team
Our Location
Contact Us
WHAT'S HAPPENING
GET CONNECTED
Worship With Us
Church Directory
Small Groups
Discipleship
Youth
Kids
Young Adult
Other Ministries
MAKE A DIFFERENCE
Give
Serve
Manna
Global
GIVE
Moms with Grace Registration
*
Indicates required field
Name:
*
First
Last
Address:
*
Line 1
Line 2
City
State
Zip Code
Country
Phone Number:
*
Alternate Phone Number:
*
Email:
*
Birthday:
*
Choose One
*
Single
Married
If Applicable, Husband’s Name:
*
First
Last
[object Object]
Anniversary:
*
Home church (if applicable):
*
Have you attended a Moms group before?
*
Yes
No
If yes, where?
*
How did you hear about this Moms group?
*
Child(ren) who
WILL
attend Children with Grace:
Name:
*
First
Last
Birthday:
*
Known Allergies:
*
Name
*
First
Last
Birthday:
*
Known Allergies:
*
Name
*
First
Last
Birthday:
*
Known Allergies:
*
Child(ren) who
WILL NOT
be attending:
Name:
*
First
Last
Birthday:
*
Name:
*
First
Last
Birthday:
*
Name:
*
First
Last
Birthday:
*
Name:
*
First
Last
Birthday:
*
Moms with Grace dues if paid in full BEFORE May 31st (early registration)....
$15
Moms with Grace dues if paid AFTER May31st (regular registration)...............
$20
or $3/meeting
*Please return completed form with your Moms with Grace dues by May 31
st
, (check payable to “Moms with Grace”) to registration table or mail to:
Grace Marks
421 W. Main St.
Kutztown, PA 19530
Submit