Ministry Adventure Plan

Kernersville Greensboro Home

If you have already filled out this form on line please do not submit another copy, log on and make changes to the original form.
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Required fields are marked with an *.

* I agree with the Statement of Faith without reservation. Yes No
* I have been immersion baptized. Yes No

* I accepted Jesus Christ as my savior in

(Year) What does this mean?

* First Name

* Last Name

Address

City

State

Zip

Primarily Attend

Home Phone

Cell Phone

Best time to call

* Email

* Birthdate

mm/dd/yyyy

(If you're under 18 a parental signature will be required)

Male Female

Do you have any health limitations?
Yes No

Marital Status

Spouse's Name (if married)

Number of Children

Trade or Profession

Picture

To aid our church staff in getting to know you, we ask that you upload a portait type picture of yourself. A picture is required to complete your sign up process. If you are unable to post a picture, please visit the church office and we will take a picture for you.

Please send all pictures in .jpg format.

* I began attending Calvary Chapel regularly...
(Give an approximate date even if you don't know exactly)

format mm/dd/yyyy