2024 New Covenant Church Community Christmas Registration

New Covenant Church Community Christmas Outreach

Registration is Closed
New Registrations Will go on a Waitlist

• Parents/Guadians need to complete this form

• Sponsor/Referrer Name Required

• All persons must live in the same home. Children ages 1-11

• NOTE: We have reached capacity for Fathers & Families Center. Thank You!

QUESTIONS? Leave voicemail at (317)205-6000

4625 North Keystone Avenue ~ www.NewCovenant.org

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We look forward to visiting you at your home or apartment to deliver a food box, gifts, and have prayer with you & your family!

If registration is accepted, we will contact you to arrange a time to visit between December 15 - 22 during daylight hours.

NOTE: We will not share your information with anyone.
Provide Sponsor's Name *

First NameLast Name
Provide Sponsor Organization *
Your name: Individual / Parent / Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Telephone Number (we will text you)*
Your Email (if available)
We are providing gifts for 1-2 parents/guardians and up to five children, infant to 11 years old, LIVING IN THE SAME HOUSE. No friends or relatives. Thank you!
CHILD #1
CHILD #2
CHILD #3
CHILD #4
CHILD #5
Comments
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