Name

Spouse's Name

Email

Phone Number

Address

Marital Status

SingleEngagedMarriedDivorcedUnspecified

Birthday

Today at LifeCity, I am a...

UnspecifiedFirst Time GuestSecond Time GuestRegular attenderLifeCity is my church home!

How did you hear about LifeCity?

FriendFacebookMailerSearched onlineOther

Today I decided...

Unspecifiedto put my trust in Jesus for the first time.I want to get baptized.I want to RSVP to the next NextSteps.

Would you like to receive our weekly "In The Know" email? (required)

YesNo

Other Comments?

Δ