Small Group Registration Form

To register for our small group, please fill out the following form and click the “Submit” button below.

Name *

First

Last

Address *

Address Line 1

City

AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Email *

Best Phone Number to Reach Me *

The Above Number Is:

• cell
• home
• work

Birthday – Month

Birthday – Day

Preferred Group (select one)

• Men
• Women
• Praise Team / Choir
• Ushers
• College
• Youth

Preferred Meeting Days (check as many as you prefer) *

• Sunday
• Monday
• Tuesday
• Wednesday
• Thursday
• Friday
• Saturday

More groups are coming as more people volunteer to lead.

I would join if the following group is available (select one):

• Married Couples
• Singles
• Young Adults
• Regional (town or area)
• Other (please explain in Comments below)

Consider leading a small group.

• I am interested in leading a group.

Comments or Questions

Submit