Event Registration Form
Register to attend the 'She is Restored' ladies event at Pelham Church
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
How many people (including yourself) are you registering?
*
Do you need nursery child care during the event for children 5 years old and under?
Yes
No
Would you like to prepay online $15 for a special K&L Jewelry piece?
Yes, prepay online
No jewelry
No, pay in person
Forever Jewelry Piece Pre-Payment
You can pre-pay $15 for a forever jewelry piece now, or choose to pay and get it on arrival.
Select your option for the forever jewelry piece
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K&L Forever Jewelry
Pre-pay $15 for your K&L Forever Jewelry piece
$
15.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
Register
Should be Empty: