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Connection Dinners Online Registration

After you complete this form you will receive an e-mail confirming your registration.  We will do our best to meet your requests as we put groups together. After groups are formed, you will be contacted by your group host coordinator to plan the first dinner.  For more information contact Wendy at wendys@waysidechapel.org or 344-1203 ext. 155.     

Sign up now for the next session!

First Name  Last Name
Spouse
Address
City  State  Zip
Phone number
email

Session in which you want to participate:

Special requests:

Type of group:
Number of children (family group only):  
Children's ages (family group only):

I would like to serve as a group host coordinator.

I would like to be placed in a dinner group with individuals in my age range if possible:  Age group:

I would like to be placed in a group with people near my zip code if possible.   

Day(s) of the week that are best for me: