All questions marked by an asterisk are required
Event Name:
Small Group Participant Interest Form
*First Name:
*Last Name:
*Phone Number:
{xxx-xxx-xxxx}
*Email Address:
*Retype Email Address:
Changing your email address will
not
change your login ID to the new address.
*Address:
*City:
*State/Province/Region:
*Zip/Postal Code:
*Which Church of the Resurrection location do you most frequently attend? :
Leawood
Downtown
West
Blue Springs
Overland Park
Online
None of the above
*Are you most interested in attending a small group that is :
Online
In-Person
No preference
Save Information:
{Checking this option will save your information for future registrations}