Breaking Bread Name* First Last Email Address 1* Email Address 2 This is for your spouse (or +1) to also be included in the email correspondence.Phone NumberNumber AttendingChildren's Ages (if applicable)Are you willing to host at your home?* Yes No Are you willing to serve as coordinator of your group?* Yes No The coordinator simply facilitates the communication, such as when and where your group will meet together for a meal.Dietary Restrictions or AllergiesIf there's a person or family you've never been in a group with and would like to be, please mention them below:
