St. Mary's ~ ChristLife: Discovering Christ ~ Fall 2019 Registration Form
Thank you for your interest in participating in the ChristLife: Discovering Christ Fall 2019 Session at St. Mary's. The schedule for the 7-week program is: Sundays 6pm-8:30pm September 22, 2019 through November 10, 2019 (except no session on Sunday, October 27th) in the Parish Center. There is also a retreat on Saturday, October 26, 2019 8:30am-3pm at the Columban Father's. Participants are asked to commit to attending all sessions. Dinner and dessert will be provided for each of the Sunday evening sessions and breakfast and lunch will be provided for the retreat. The registration deadline is Sunday, September 1, 2019. Space is limited, so please complete this form at your earliest convenience. Free child care is available.

Please fill out the information requested below. If you have any questions, please contact ChristLife Coordinator Tina Targy (402-709-6980|tina.targy@stmarysbellevue.com).

ask. seek. knock.
First & Last Name *
Name tags will be used during the program.
Your answer
Mailing Address - Street *
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Mailing Address - City *
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Mailing Address - State *
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Mailing Address - Zip Code *
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Email Address *
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Phone Number *
xxx-xxx-xxxx; Specify if home or cell phone. Cell phone #'s preferred, if available.
Your answer
Are you willing to make a strong effort to attend all the sessions (Sundays 6pm-8:30pm September 22nd through November 10th; Retreat Saturday 8:30am-3pm October 26th (no session October 27th)? *
Do you have a seating preference? *
If you know of someone else participating in the pilot and you would like to be seated with them, please list their name (even if it's your spouse since some spouses want to be sat together and others do not, so we do not want to make an assumption about your preference). If you have any general requests about seating, please include those as well. These requests may not be possible, but we will take them into consideration.
Your answer
What is your religious denomination? *
Do you have a church that you attend? If so, please list name and city. *
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What is your age range? *
Do you plan to take advantage of the free child care? *
Please list yes/no. If yes, list the ages (months if baby) of your child/children and if they have any dietary restrictions. Also, if you list "yes", the assumption would be that care is needed for all Sunday sessions and the Saturday retreat. If that is not the case, please list the exceptions.
Your answer
Do you have any dietary restrictions? *
(e.g., gluten free, nut allergy, etc.)
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Have you previously attended any of the following? *
If you marked any above, when and where? *
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Which most closely describes your current relationship with Jesus? *
How did you hear about this opportunity?
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Is there anything else you would like to ask/share? *
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