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My Hurts Group Registration Form

The King's Daughters Ministry Hurts Group REGISTRATION FORM

Please complete the registration form below and click "SUBMIT" at the end.

You will receive an email confirmation receipt of your registration.

If you do not receive a response from our office within two business days,
please contact us at 704-263-4204.

Contact Information

Name

First Name

Last Name

Phone

Verify Email

Birth Date

All minors must be accompanied by parent or guardian.

Gender at Birth?

Female

Male

Group Meeting Options

Monday Evenings 6:30pm

You chose "Other". How did you hear about this group?

Do you have any special accommodation needs during group?

Yes

Please note specific special accommodations needed.

Additional Notes/Questions?