NEW MEMBER CLASS

Name *

First Name

Last Name

Home Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Home Phone

(###)

###

####

Cell Phone

(###)

###

####

Permission to Receive Texts?

Select "Yes" to receive text reminders and alerts from the church at this number. You may opt out at any time.

Yes

No

Date of Birth *

MM

DD

YYYY

Baptism, Faith, & Membership

Check all that apply

Baptized

Professing Member of a Church

Ready to Make Profession of Faith

Wedding Anniversary (if married)

MM

DD

YYYY

Name

First Name

Last Name

Cell Phone

(###)

###

####

Permission to Receive Texts?

Select "Yes" to receive text reminders and alerts from the church at this number. You may opt out at any time.

Yes

No

Date of Birth

MM

DD

YYYY

Baptism, Faith, & Membership

Check all that apply

Baptized

Professing Member of a Church

Ready to Make Profession of Faith

Date of Birth

MM

DD

YYYY

Baptism, Faith, & Membership

Check all that apply

Baptized

Professing Member of a Church

Ready to Make Profession of Faith

Date of Birth

MM

DD

YYYY

Baptism, Faith, & Membership

Check all that apply

Baptized

Professing Member of a Church

Ready to Make Profession of Faith

Date of Birth

MM

DD

YYYY

Baptism, Faith, & Membership

Check all that apply

Baptized

Professing Member of a Church

Ready to Make Profession of Faith

Date of Birth

MM

DD

YYYY

Baptism, Faith, & Membership

Check all that apply

Baptized

Professing Member of a Church

Ready to Make Profession of Faith

Childcare *

We encourage participants with young children to arrange child care with a family member, friend, or other child care provider. However, we do not want a lack of child care to inhibit participation in the class. Please check "Yes" if you need assistance making child care arrangements in order to attend, and describe your need (ages of children, day(s) care is needed, etc.) in the comments below.

Yes, I need assistance with child care.

No, I do not need assistance with child care. (If your needs change, please contact us at admin@christcovenant.church prior to the registration deadline to provide us with adequate time to assist you.)