New Member 18&Under

"Where Christ is the way and the Word is clear"

New Member Enrollment Form For Members Under 18
TODAY'S DATE

MonthDayYear
Date
SERVICE TIME
SundayTuesdayCommunionOther
If (other) please describe
NAME
STREET ADDRESS
APT #
CITY
STATE
ZIP
PHONE: (Home)
Format: (000) 000-0000.
(Cell Number)
Format: (000) 000-0000.
EMAIL
example@example.com
DATE OF BIRTH

MonthDayYear
Date
ENVELOPE NUMBER
YesNo
MaleFemale
If you are under the age 18 please provide your parents name's and phone number and have one of them sign below:
PARENT/GUARDIAN NAME (PRINT)
PHONE NUMBER
Format: (000) 000-0000.
PARENT/GUARDIAN NAME (SIGNATURE)

Clear
New Christian (today)RecommitmentAlready a ChristianWatchcare
YesNo
New Member Follow up Steward
Should be Empty: