Women’s Welcome (Christ Renews His Parish) Registration

Name*
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Email*
Emergency Contact Name*
First Last
Emergency Contact Phone Number*
Which beverages do you prefer?*
- Water
- Regular Soda
- Diet Soda
- Sprite/Sierra Mist
- Coffee
- Tea
Special Accommodations ~ physical, etc.*
No steps, room by elevator, etc. If no accommodations required, answer "none."
Dietary Restrictions ~ allergy info., etc.*
Please add any special dietary needs you may have. If no dietary restrictions, answer "none."