Please complete this on line form to register for

Messy Church @ Mosley Common

for FRIDAY 28th February 2020 at 3.15pm

Children's name(s):*
Number of Children:*	1 2 3 4 5 6
Number of Adults:	1 2 3
Age of Children:
Contact Number:*
Contact Email:
Please enter the verification number on the right:*
* Required Fields