Instructions

1. Fill out this form completely.
2. When done, click on "Register" toward the bottom of the page.
3. For questions, please call Marc Jantomaso at 434.660.7729 or e-mail him at MarcJantomaso@verizon.net

Head of Household

Spouse
Number of Children

Children's names and ages

Address 1

Address 2

City

 State Zip

Phone

e-mail

Church affiliation
Please indicate if you are a church leader.
Would like to be available as a host home for those traveling from outside the area Yes No
Would like to volunteer to help as needed Yes No
Would like to bring art for the Scripture Art Gallery Yes No What is this?
Would like to enter Photo contest Yes No What is this?
Will you join us Sunday for worship together (all ages) from 10-11:30am? - Location TBA. Yes No  


For more information please contact:

Marc Jantomaso
MarcJantomaso@verizon.net
434.660.7729
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