Contact information

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Contact information

Please fill out one form for each member of your household.

Name *

Address *

Home phone number

Cell phone number

Birthday *

YYYY

Anniversary

YYYY

I give permission to... *

Receive church emails

Receive prayer requests by email

Receive occasional text message alerts

Receive phone calls

Show photos of me on the website

I do not give permission for any of the above

Required

I give permission to include the following information in the password-protected directory: *

Name

Address

Home phone number

Cell phone number

Email address

I do not want my information published in the directory

Required

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