Connect Card

First Name *

Last Name

Email Address *

Phone *

Is it okay if we communicate via text? *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP Code *

Birthdate *

Gender *

Marital status *

Household membersAdd ChildAdd Adult

Household members :: Child

First Name

Last Name

GenderMaleFemale

Birthdate

Grade

Medical notesMedical notes may be printed on name tags.

Household members :: Adult

First Name

Last Name

Email Address

Phone

GenderMaleFemale

Birthdate

Marital status

Please share how you'd like to connect. (check all that apply) *I am visiting for the first time.I would like to talk with someone about what it means to follow Jesus.I would like to talk to someone about getting baptized.I'm interested in church membership.I would like a call from a pastor.I would like to get connected and/or volunteer.I would like to meet with the pastor.I'm interested in opportunities to grow in my faith.Other

How did you hear about us? *

Prayer RequestPlease PrayIf you have a prayer need, please check this box and fill in your request below. Our Care Team would love to pray for you.

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