One Night – Guest – New Life Baptist Church

For those registering multiple guest please fill out a separate form for each guest but list the attending caregivers or family members on one form.

Guest Name(Required)

Full Name

Address(Required)

Street Address City State / Province / Region ZIP / Postal Code

Phone(Required)

Names of all family members or care givers attending with guest:(Required)

Put NA if you are filling out multiple guest form and have already provided this content.

Menu Option: Choose Between Grilled Chicken and BBQ Pork for guest and family members/care givers(Required)

List any dietary restrictions and allergies(Required)

Will the guest require physical assistance?(Required)

Yes, Wheelchair

Yes, Walker

Please list any accommodations we need to make to ensure this is a special evening for our guest.