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Hearts for
Health

 
     

Saturday, March 9, 2019 (Rescheduled)
Ophelia's Restaurant
201 North Main Street
Independence, Missouri 64050

Supporting the work of
The Health Ministries Association

 $50.00 Adults, $20.00 Children (3-12)

  Required Fields

To:

Health@HMACofChrist.org

Reservation 1 - Name:

Address:

 

City:

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ZIP:

Phone:

E-Mail:

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If this is a group registration, fill in the additional members of your group below.

Reservation 2 - Name:

Reservation 3 - Name:

Reservation 4 - Name:

Reservation 5 - Name:

Reservation 6 - Name:

Reservation 7 - Name:

Reservation 8 - Name:

 

Additional Information:

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E-Mail Sent Using This Form Will Be Delivered To: Health@HMACofChrist.org
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Health Ministries Association  Community of Christ International Headquarters 1001 West Walnut  Independence
Community of Christ
Health Ministries Association
Community of Christ Affiliate
Donation Donation Donation Donation Donation

1001 West Walnut, Independence, Missouri 64050-3562  U.S.A.

800.825.2806 Ext. 1262

816.833.1000 Ext. 1262

FAX:  816.521.3084

Community of Christ Health Ministries Association is a 501(c)(3) non-profit health organization supported solely by donations and gifts made
directly to HMA. For written permission to use the HMA logo on your publication or website, please contact the office 816.833.1000 ext.1418.

Updated 2/20/19