Closing Ceremony form — Wynne Kairos

Registration for WYnne #18 Closing

————————————————————————-

You must register to attend Closing — even if you have attended a previous Closing.

Don’t wait! Sign up now. The deadline to sign up is September 28th.

————————————————————————-

Please fill out all of the information below.

Name as on drivers license

First Name

Last Name

Home Church or Location

Driver's License Number (Last 4 digits, and state)

Phone

(###)

###

####

Former Offender?

Please check, if yes. Special permission is required from the Warden.