Holiday Service Registration

To have a child's name listed in the program, please submit this information by November 19, 2017.

Names received after this date will be listed on a program insert. Names will be accepted through the start of the Service on December 3, 2017.

Names are NOT held over from year to year. You must submit names every year.


Parents Name(s):
Address:
City/State/ZIP:
Phone:
Cell:
E-mail:
If you are not the child's parent, your name:
Your Phone:
Your Cell:
Your E-mail:

I/We would like to take part in the Holiday Service of Remembrance by:

Title/Author/Instrument:

I/We would like to have the following child / children remembered during the service: