Valley Dads' Group Registration
Are you a dad to a child/adult with special needs - chronically ill, medically fragile or learns differently? Valley Church has a special needs ministry and this is our Dads Group. Join other dads facing similar struggles you do. Complete this form so we can get to know you and include you in our email group for updates and opportunities.
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Name, first *
Name, last *
Birthday *
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DD
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YYYY
Address *
City *
State *
Zip code *
Email Address *
Cell Phone # *
Anniversary - if married *
MM
/
DD
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YYYY
Favorite Drink *
Home Church *
I would like information for what Valley Church has to offer us on: *
What would you like to get from this group? *
What would you like to share about your loved one with special needs? *
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