Life-group Enrollment Form
 (The information submitted in this form is secure and will be used solely for the purpose of organizing home groups and will not be used for any other purpose or given out to any other party.)

(Please fill out the entire form. Couples attending together only complete the form once)

First Name(s)   Last Name 
E-Mail:
Street Address:   City:   Zip:
Home Phone: -

I am interested in joining a LIFE Group that...
includes children/teens   has adults only
      ...that meets on:
               

Please Check if applicable:

  I am interested in becoming a Host Home.
  I am already in a LIFE Group and wish to stay.
               Please indicate current host home:
  I will continue to be a host home.

Comments:

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