Registration for 2017 Christmas Brunch For Moms Who Have Lost Children

ONLINE REGISTRATION AT THE BOTTOM OF THIS PAGE FOR MOMS:

IMPORTANT NOTE: **SPECIAL TRIBUTE SLIDE PRESENTATION**

If you would like to have a photo of your child included in our special tribute slide presentation, please email or mail us the following (By November 29, 2017):

(PLEASE NOTE THAT INFO PROVIDED TO US IN PREVIOUS YEARS WILL NOT NEED TO BE RESENT AS IT WILL AUTOMATICALLY BE INCLUDED IN THIS YEAR’S TRIBUTE.)

PHOTO OF YOUR CHILD

THE NAME OF YOUR CHILD

DATE OF BIRTH

DATE OF DEATH

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EMAIL: Sharon@wildernessgrace.org;   …OR

MAIL:

GRACE IN THE WILDERNESS MINISTRIES, PO BOX 14848, GREENVILLE, SC 29610

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ONLINE REGISTRATION:

Your Name (required)

Your Email (required)

Your Address (required)

Your Phone Number

Are you a Mom (Birth, Adoptive or Foster) who has lost a child? (Please choose yes or no in dropdown below) (required)

Comments or Questions:

THANK YOU!

 

 

 

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