Last Name

First Name

Preferred First Name for Name Tag

Spouse's Name

Street Address

City

State

ZIP Code

Phone (Preferred for contact)

Alternate Phone

Email Address

Church you attend

COVENANT AGREEMENT: I desire to enter into a fellowship of encouragement, challenge, and accountability. I agree to timely, faithful attendance, unless providentially hindered. I agree to be prepared and to participate in the small group discussions, while respecting group confidentiality. COVENANT AGREEMENT: I desire to enter into a fellowship of encouragement, challenge, and accountability. I agree to timely, faithful attendance, unless providentially hindered. I agree to be prepared and to participate in the small group discussions, while respecting group confidentiality. I AGREE