Sunday Services at 10:30am at Five Points Washington


beMOM Registration

As a reminder: A yearly registration fee of $75 will be due in September to help cover the cost of childcare and other ministry expenses. If cost is an issue, just let us know. We don't want anyone to be unable to attend due to finances.        


* = required field

Your Information

*Name

*Address

Address Line 2

*City

*Zip

*Email address

Phone

Birthday

Check one:




*Do you have children that will be attending our provided childcare?



Name (first and last) and Birth date of Children Attending:

Please indicate any allergies or special needs of children attending

How did you learn about beMOM? Who invited you?

Do you attend a church? If so, where?

Are there any topics you would like to discuss at beMOM?

Comments:






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