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The Love and Marriage Experience Registration

Inscripción en español

Last Name*
Husband's first name
Wife's first name
Address
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Husband's phone
Wife's phone
Email
Do you plan to attend the bowling "Meet & Greet" at Desert Strike Lanes (Fort Bliss) March 18? Purchase of shoe rental/games required.*
Do you plan to attend the Single's Night Out Dinner at Logan's Roadhouse? Pricing approx. $20/person.
Will you be registering to participate in our couples or singles workshops?
IF YOU WILL NEED CHILDCARE DURING THE SEMINAR, please fill out the information below for each child 10 and under:
Child #1 Name
First Name
Middle
Last Name
Age
Child #2 Name
First Name
Middle
Last Name
Age
Child #3 Name
First Name
Middle
Last Name
Age
Child #4 Name
First Name
Middle
Last Name
Age
Child #5 Name
First Name
Middle
Last Name
Age