Limited seating. Register now!

 **FIELDS ARE REQUIRED**

**Attendee #1:

Attendee #2:

Attendee #3:

Attendee #4:

**Email:
**Street Address:
**City,State:
**Zip:
Phone:
**Number of Attendees:
Church:
Invite a Friend (add email address here):
Comments:

If you would care to pay with a check,
make payable to "Lifeline Community" and send to:
4037 WEST NIKE DR. UNIT H  
WEST JORDAN, UT 84088
801-280-8747
(Please allow 7 days for processing)
 
RETURN