Journey Groups Registration

Name:

*

Phone:

*

Email:

*

Name(s) of others you would like to have in the same group:

Your Age Group:

*

College	20s	30s	40s
50s	60s	70s Plus

Gender:

*

Female Male

Marital Status:

*

Single Married Divorced Widow(er)

Do you have children?

*

Yes No

If Yes, age of children: (Check all that apply)

*

Preschool	Elementary	Middle School
High School	Empty Nest

Do you need childcare?

*

Yes No

What type of group interests you? (Check all that apply)

*

New Believers	Life-Stage
Multi-generational	Same Gender