Chalice Circle Registration Form

The Chalice Circle registration deadline for Chalice Circles beginning in April 2013 is Sunday, March 17. However, newcomers to the church can sign up for Chalice Circles at any time.

Please fill out the form below. Please use correct capitalization and punctuation because this information may be used to mail you information about your Chalice Circle.

Chalice Circles beginning in April 2013 will meet six times between April and June. Chalice Circles usually meet the first and third weeks of the month. Please select your preferences for the times you would like to participate on the form below. Selecting more times will make it more likely for your participate. Please do not sign up for Chalice Circles if you know already that you will not be able to attend most meetings.

First Name: *

Last Name: *

Street Address: *

City: *

State/Province: *

Zip: *

Home Phone: *

Work or Mobile Phone:

Email: *

First Preference: *

Second Preference:

Third Preference:

Fourth Preference:

Fifth Preference:

Sixth Preference:

Seventh Preference:

Other Options:

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 before.

If possible, I'd like to be in a different Chalicice Circle than before.

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.

I am interested in participating in an online Chalice Circle. (To participate in an online Chalice Circle you must have a computer, a webcam, microphone, headphones, and a high-speed Internet connection.)

Check any of the following that apply:

Childcare:

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

Special Needs:

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

Saltwater Church...A Unitarian Universalist Congregation

Primary links

Chalice Circle Registration Form