South Bend First Baptist

Street Address

City, State, Zip

Phone Number

South Bend WA

Your Custom Text Here

South Bend First Baptist

Couples Valentines Dinner Registration

Please complete the form below

Guest #1

First Name

Last Name

Meat of Choice

Guest #2

First Name

Last Name

Meat of Choice

Phone

(###)

###

####

Email

Cost per couple

Please be prepared to pay at the door!

$40