Once Upon A Time - Date Night Registration
Friday, September 23 at 7 p.m. in the Multi-Purpose Room.

Whether you met 3 years ago or 53 years ago, come and take a step back in time. Remember when you first met...your first date...

To register, fill out the form below. We want to be able to personalize the date as much as possible. If you don't see your "like", don't hesitate to write it in!

If you have any questions, contact Dolores Shipe at 412-661-3100 x127 or 412-760-3177 or email dshipe@straphaelpgh.org.

Husband's name *
Your answer
Wife's name *
Your answer
Phone number
Your answer
Email Address
Your answer
His favorite drink: *
If other, please describe:
Your answer
Her favorite drink: *
If other, please describe:
Your answer
His favorite snack: *
If other, please describe:
Your answer
Her favorite snack: *
If other, please describe: *
Your answer
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