Full Name (required)

Email Address (required)

Mailing Address

Cell Phone

Alternate Phone (Home/Work)

Name of Workshop(s) for this Registration (required)

Comments: (special needs, requests, etc.)

All registrations will be confirmed by e-mail. If you do not receive a confirmation e-mail within two business days, please contact Rev. Sarah Kromer at 704-554-2490 or [email protected].

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