I Accepted Christ!
Please complete the information below so that we may be celebrate the decision you've made to accept Jesus Christ as Lord and Savior
Full Name
*
First Name
Last Name
Primary Phone Number
*
E-mail
*
How can we serve you?
*
Please Select
I need prayer
I would like to accept Christ / I just accepted Christ
I would like to join
Request Salvation
We’re glad to hear of your interest in, or acceptance of, Jesus Christ. Please tell us a little more about you so that we can help you transition into your new life in Christ.
If I'm between the ages of 5-15 years old, I understand that my parents must be notified.
Yes
No
If you're between the ages of 5-15 years old, please select your age below.
Please Select
5
6
7
8
9
10
11
12
13
14
15
Cell Phone Number
If different from above.
Work Phone Number
If different from above.
Gender
Please Select
Male
Female
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How did you hear about The Park Church?
Radio
TV
Friend
Yellow Pages
Other
Membership Information
Thank you for your interest in joining our church. We’d love to welcome you into what God is doing through The Park. Please tell us a little more about you.
Campus Attended
Please Select
Online
Beatties Ford Road
Date of Birth
-
Month
-
Day
Year
Date
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gender
Please Select
Male
Female
Marital Status
Please Select
Married
Single
Widowed
Divorced
Separated
Occupation
Are you related to a member of The Park Church?
Please Select
Yes
No
Member Name
Member Relationship
Are you a college student?
Please Select
Yes
No
What college do you attend?
Emergency Contact Name
First Name
Last Name
Emergency Contact Number
Please enter a valid phone number.
I desire membership by...
Please Select
Baptism (I want to baptized into the Christian faith by water immersion)
Christian Experience/Letter (I was a member of another Christian church and I have accepted Jesus Christ as my personal Savior and/or letter will be sent from my previous church)
Watch Care ( am in Charlotte temporarily for work or school; and am currently a member of another church)
Restoration (I am a former member of this church and I would like to be restored back into membership)
Other
Name and location of current church
Last date of attendance
-
Month
-
Day
Year
Date
Question / Comment
Please verify that you are human
*
Send message
Clear Form
Should be Empty: