根源教會秋季退修會報名 Roots Church 2021 Fall Retreat Registration
我要報名 I would like to register: *
中文名字 Chinese name *
如果沒有的話請寫「沒有」。If not applicable, write N/A.
英文名字 English name *
如果沒有的話請寫「沒有」。If not applicable, write N/A.
慣用稱呼 Preferred name *
電話號碼 Phone number *
電子郵件 Email *
室友的要求 Roommate requests
食物過敏,其他注意事項或問題 Food allergies, additional notes, or questions
需要報名兒童照護? Do you need to register any children? *
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