Emmaus Small Group Participant Registration
Thank you for your interest in joining an Emmaus Small Group. Please fill out the information below to register. Married couples need to register as separate individuals to be added to groups properly.
First Name: *
Your answer
Last Name: *
Your answer
Email: *
Your answer
Phone (xxx-xxx-xxxx): *
Your answer
Cross Roads & City: (Not full address) *
Your answer
I would prefer to meet: *
Required
Time of day you prefer to meet (indicate all the days you are available to meet):
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Mornings
Afternoon
Evenings
Please indicate your group membership preference: *
Required
My first preference of a group to join is: *
My second preference of a group to join is: *
My third preference of a group to join is:
Please list any food or pet allergies:
Your answer
I am possibly interested in (select all that apply): *
Required
If you indicated you are willing to be a host, please list types of pets in your home:
Your answer
If you are willing to host a group, are you willing to offer/coordinate childcare?
Other comments or helpful suggestions?
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