A Patriot's Heart Performance and Luncheon

Sunday, July 20, at 11:30a.m. | Please fill out this form and click submit.

Name

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Email

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Phone

Church Home

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St. Cuthbert Episcopal Church Emmanuel Episcopal St. Aidan's Episcopal St. Mary's Episcopal St. Paul's Episcopal Other None

Do you or anyone attending with you have any food allergies?

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Child care will be provided for children ages 10 years old and under.

Do you need child care?

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Yes No

List child/ children name and ages and any allergies.

Name of Additional Guests

Payment - $10 per person

Credit Card Cash/Check ($0.00)

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Expiration Date/CVC

Name on Card

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Description

Sunday, July 20, at 11:30a.m.

Please fill out this form and click submit.

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