Mosaic Women's Ministry

Saturday, November 16th at 6 pm

Join us for a night of encouragement and holiday cheer. The Dinner is FREE for those who have registered.

ATTENDEE REGISTRATION FORM

Name

First Name

Last Name

Email

Phone

(###)

###

####

Childcare is available but only for preregistered children, ages 8 and under. Do you need childcare?

Yes

No

Please list the names and ages of your children that need childcare.