Saturday Supper: Fall Edition Saturday, November 21, 2020 Registration Form Last Name First Name Street Address City State Zip Code Email Address Telephone Number Number of People in the Home? My current status is: My current status is: Unemployed Sick and Shut-In Senior Age Do you have Dietary Restrictions? Do you have Dietary Restrictions? Yes No Do you have Food Allergies? Do you have Food Allergies? Yes No CBC Visitor Only - Please complete items below: Your Church of Worship Your Pastor 8 + 1 = Submit