Chalice Circle Online Registration Form

To find out more about Chalice Circles in general, click here.

The Chalice Circle registration deadline for Chalice Circles beginning in January 2009 is Sunday, December 14.

You may also download a printable version of this form by clicking here.

Please provide the following contact information:

First Name

Last Name

Street Address

Address (continued)

City

State/Province

Zip/Postal Code

Work Phone

Home Phone

E-mail

Chalice Circles beginning in January 2009 meet six times between January and March. Chalice Circles usually meet the first and third weeks of the month. Please select the times you are available to participate. Selecting more times will make it more likely for you to participate. Please do not sign up for Chalice Circles if you know already that you will not be able to attend most meetings.

Please note that if there is enough interest, there will be a Chalice Circle that meets at 11 a.m. on Sunday mornings, and childcare will be available for this Chalice Circle.

            First preference:
            Second preference:
            Third preference:
            Fourth preference:
            Fifth preference:
            Sixth preference:
            Seventh preference:

Check any of the following that apply:

I am interested in being a Chalice Circle facilitator or assistant facilitator.
I am interested in hosting a Chalice Circle in my home.
I require childcare in order to participate.
If possible, I'd like to be in the same Chalice Circle as Fall 2008.
If possible, I'd like to be in a different Chalice Circle as Fall 2008.
If possible, I'd like to be in a Chalice Circle for men only.
If possible, I'd like to be in a Chalice Circle for women only.

If you need childcare, what are the names and ages of the children for whom you need childcare:

Do you have any special needs regarding participating in a Chalice Circle or anything else that you would like us to know?

Please contact Reverend James Kubal-Komoto at minister@saltwaterchurch.org or at (253) 839-5200 if you have questions about registering for Chalice Circles.