YOUTH MEMBERSHIP FORM
Welcome to Monumental Baptist Church! We’re delighted you’ve decided to take this next step. Please take a moment to fill out the form below and someone from our team will be in touch with you soon.
About Me!
Tell us a little about yourself
Name
*
First Name
Middle Name
Last Name
Suffix
Date of Birth
*
/
Month
/
Day
Year
Date
Allergies or Medical Conditions (if any)
*
If none, fill in N/A in box above
My Family!
Who do you live with?
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
Please Select
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Connecticut
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District of Columbia
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Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
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Mississippi
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Montana
Nebraska
Nevada
New Hampshire
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New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
In Case of Emergency!
Who should we call if something happens?
Same as above
*
Yes
No
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
My Siblings!
Do you have any brothers or sisters?
Sibling(s) Name + Age
Your Faith Journey!
Tell Us Your Story!
Why do you want to join our church? (Choose one)
I want to learn more about Jesus!
I already love Jesus and want to be part of this church
I’m coming back to church after a while
Other
Have you been water baptized?
*
Please Select
Yes
No
I'm not sure
Previous Church Name
Smile For The Camera!
Can we take pictures of you at church and events?
I give permission for pictures of me to be taken at church events and shared in promotional materials or on social media.
Please Select
Yes
No
How Did You Find Us?
Where did you hear about our church?
How did you learn about Monumental Baptist Church?
*
A Friend Told Me
I Saw It on Social Media
I Found It on the Internet
I Went to a Church Event
I Saw A Sign Outside
Other
Additional Questions or Comments:
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