Room In the Inn Church/Group Registration Form
January and February 2020
326 South Main Street, Mount Airy, NC
Contact us at (336) 786-2803 or lynn@fpcma.com
Church Name *
Your answer
Team/ Church Coordinator Person *
Your answer
Team/ Church Coordinator Person Email *
Your answer
Team/ Church Coordinator Person Phone Number *
Your answer
Back-Up Contact Person *
Your answer
Back-Up Contact Person Email *
Your answer
Back-Up Contact Person Phone Number *
Your answer
Preferred Night to serve *
MM
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DD
/
YYYY
2nd preference of Night to serve *
MM
/
DD
/
YYYY
3rd Preferred of Night to serve *
MM
/
DD
/
YYYY
Comments/Questions
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