Regency Baptist Church Family Directory

CHURCH FAMILY DIRECTORY
Thank you for taking the time to fill out this form!

Only one form is needed per family if everyone is living at the same address. Should you have a college/military student living away from home, please submit a new form just for them.

The information collected here is only for the church directory, church members and church staff. Your information will not be shared or sold to any other person or organization without your consent. Your security and privacy is important to us.
First Name*
Last Name*
Spouse's Name (if applicable)

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please provide us with at least one point of contact.
Home Phone Number
Please enter a valid phone number.
Mobile Number
Please enter a valid phone number.
Spouse's Mobile Number
Please enter a valid phone number.
Email Address
example@example.com
Spouse's Email Address
example@example.com
Preferred Contact (We will need at least one point of contact)*

Home PhoneMobileTextEmail
Do you consent to be added to the church's text and/or email list? (The list will remain private and will not be shared with any third parties)*

YesNo
Birthday*
MM-DD-YYYY
Spouse's Birthday*
MM-DD-YYYY
Wedding Anniversary*
MM-DD-YYYY
Children's Names and Birthdays (if applicable)
Ministries Your Family Are Involved In (check all that apply)
Ministries Your Family Are Interested In (check all that apply)
I give Regency Baptist Church permission to include the above information in the Church Directory.
Signature

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CHURCH FAMILY DIRECTORY