Growth Groups Adult Registration
Please complete this registration form using the fields and options from the referenced PDF.
Participant Information
Full Name
*
First Name
Middle Name
Last Name
Preferred Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
Gender
Female
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Address
City
State
ZIP
Referral and Participation Details
How did you hear about Bold Enough Growth Groups?
Social Media
Friend/Family
Church
Website
Event
Other
How did you hear about us? - Other (please specify)
What are you hoping to gain from participating?
Tell us about your spiritual journey
New Christian (< 3 years)
Christian – needing additional spiritual growth
Non-Christian (seeking to understand)
Mature Christian (Needing personal growth and support)
Other
Spiritual journey - Other (please specify)
Please tell us in your own words about your personal and spiritual journey
Preferred Day/Time
Tuesday Evenings
Tuesday Mornings
Wednesday Evenings
Thursday Evenings
Thursday Mornings
Other
Preferred Day/Time - Other (please advise)
Eligibility and Growth Preferences
Are you willing to participate respectfully in Bible-based discussions and activities?
*
Yes
No
Do you consider yourself a follower of Jesus Christ?
*
Yes
No
Exploring My Faith
What area of spiritual growth would you most like to develop?
*
Faith
Prayer
Bible Study
Identity in Christ
Relationships
Emotional Healing
Purpose & Calling
Other
Spiritual growth area - Other (please specify)
Is there anything you would like the Growth Group leader to know about your goals for participation?
Emergency Contact and Participant Acknowledgements
Emergency Contact Name
*
Emergency Contact Relationship
*
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Emergency Contact Alternate Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Participant Agreement - Initials
*
Media Release & Authorization
*
YES, I authorize use of my image or likeness
NO, I do not authorize the use of my image or likeness
Media Release - Participant Initials
*
Participant Signature
*
Signature Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Additional Notes
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Submit
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