Breaking Bread

ATTENTION: Groups have already been formed for April-June, but we will place you on a waiting list in case we form one more group.

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 Number
Number Attending
Children'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 Allergies
If there's a person or family you've never been in a group with and would like to be, please mention them below: