Name *

First Name

Last Name

Phone *

(###)

###

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Spouse Name (if applicable)

First Name

Last Name

Spouse Phone

(###)

###

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Groups *

Please select a group(s) to join:

Adult Group #1: Win & Amanda Moore's Home

Adult Group #2: Host Home TBD

CPC Kids Bible & Music* (4yrs-5th grade)

Nursery* (2mo-3yrs)

Forge Youth* (6-12 grade)

*Child #1 Name (if Catechism Club, Forge or Nursery was selected)

First Name

Last Name

Child #2 Name

First Name

Last Name

Child #3 Name

First Name

Last Name