Small Group Registration
Small Group Information
Group Placement Request Form
We're glad you're interested in joining a group! Please fill out the form below and we'll get back you as soon as possible.
My Information
First Name
*
Last Name
*
Age
Gender
Female
Male
Street Address
*
City
*
FL
Zip Code
*
Phone
(###-###-####)
Email Address
I prefer to be contacted by:
Phone
Email
Text
Postal Mail
Help Us Find the Right Group For You
What type of group are you looking for?
Married Couples
Mixed Adult (Men & Women)
Men Only
Women Only
Spanish Speaking
Retirees
Which days fit your schedule? Select all that apply.
Sunday
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Which times of day best fit your schedule? Select all that apply.
Morning
Afternoon
Evening
I would like to learn more about leading a Small group?
Yes
No
Have you been in a group before?
Yes
No
Comments or Questions
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