Christ Memorial Church
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Cross Connections Registration Form

2008 Cross Connections Registration Form
* Required
First Name *
Last Name *
Email Address *
 
Address Line 1 *

Address Line 2
City *
State *
Zip Code *
 
Area Code
Phone Number
Home Phone *
Kid Connections Planning Information
CHILD #1 - Name:
Birthday:
Attending Kid Connections?
CHILD #2 - Name:
Birthday:
Attending Kid Connections?
CHILD #3 - Name:
Birthday:
Attending Kid Connections?
CHILD #4 - Name:
Birthday:
Attending Kid Connections?
CHILD #5 - Name:
Birthday:
Attending Kid Connections?
Additional Children or Special Instructions (e.g. allergies, etc.)
Expenses are only $2 per meeting or $18 for the whole year. This is payable at any Cross Connections meeting or via the mail. Please make checks out to "Christ Memorial Church." To pay by mail, please send to:
Kirsten Rickert
267 Hillside Drive
Williston, VT 05495





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