Address

City

State

Zip

Telephone  *

Email  *

Church

I plan to attend the Free Conference

I will stay for lunch on Saturday, 12:30 pm  *  Yes   No 

For Faith Members: I will be able to help serve or provide food for the lunch.  Yes   No 

Will you need childcare?  Yes   No 

Food allergies?

Meal for children Saturday  Yes   No