Village Well Meeting Registration
Registration closes the Thursday before the meeting to allow time to schedule childcare and planning for provided dinner.
Email *
Your answer
First Name: *
Your answer
Last Name: *
Your answer
Spouse Name:
Your answer
Phone: *
Your answer
I/We are a: *
We are serving a free dinner for your whole family at 6 pm. Will you be joining us? *
Do you require childcare? *
Please provide the child's FIRST AND LAST name
Child #1 First and Last Name
Your answer
Child #1 Age
Your answer
Child #2 First and Last Name
Your answer
Child #2 Age
Your answer
Child #3 First and Last Name
Your answer
Child #3 Age
Your answer
Child #4 First and Last Name
Your answer
Child #4 Age
Your answer
Child #5 First and Last Name
Your answer
Child #5 Age
Your answer
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This form was created inside of Newport Mesa Church.