I'm interested in being part of a Life Group at WCC. Here's my info!

Name *
First Name
Middle
Last Name
My Spouse's Name
First Name
Middle
Last Name
Address *
Address Line 1
Address Line 2
City
State/Prov.
Postal Code
Phone number where I can be reached*
This Phone is Home, Cell or Work?
Add'l Phone Number to use to reach me
This Phone is Home, Cell or Work?
Email
Age Range
Ages of Children (check all that apply)
Would you prefer to be in a Life Group for Singles?
Are you or your children allergic to pets?*
Which week night works best for you to attend? (Please choose one) *
Do you have any questions or comments?
Name*