Moms on the Wall Prayer Walk Registration
Register to join us for a morning of walking, prayer, and community as we cover our children and the next generation in prayer.
First & Last Name
*
First Name
Last Name
Email Address
*
example@example.com
Mobile Number
Please enter a valid phone number.
Format: (000) 000-0000.
City / Area
Is this your first Moms on the Wall Prayer Walk?
*
Yes
No
How did you hear about Moms on the Wall?
Friend/Family
Church
Social Media
School/Community
Other
How many children are you covering in prayer?
Would you like information about future prayer walks and gatherings?
Yes, please!
Not right now
Would you be interested in helping with a future prayer walk?
Yes, I’d love to help
Maybe—send me information
Not right now
Would you be interested in bringing Moms on the Wall to your community?
Yes, I’d love to learn more
Maybe in the future
Not right now
Prayer Request
Photo & Video Preference
Yes, I am comfortable appearing in photos or videos.
No, I prefer not to be photographed or recorded.
Participation Acknowledgment
*
I understand that Moms on the Wall is an independent community prayer gathering and is not sponsored by or affiliated with Loriella Park, local schools, Spotsylvania County Public Schools, or other locations where future walks may be held.
I understand that this is a voluntary walking activity and that I am responsible for determining whether I am able to safely participate.
I understand that event details may change due to weather or other circumstances and that updates may be sent using the contact information I provided.
Register
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