Life Group Sign Up Form

Please read and confirm that you understand the "Life Group Covenant" before submitting this form.

Session: Summer 2012 (June-August)

Name(s) (Please list separately and indicate age)

Adults
---18-25 years old26-39 years old40-55 years old56-70 years old70+ years old

---18-25 years old26-39 years old40-55 years old56-70 years old70+ years old

Children
  ---1-2 years old3-5 years old6-10 years old11-17 years old

  ---1-2 years old3-5 years old6-10 years old11-17 years old

  ---1-2 years old3-5 years old6-10 years old11-17 years old

  ---1-2 years old3-5 years old6-10 years old11-17 years old

  ---1-2 years old3-5 years old6-10 years old11-17 years old

Email

Phone

Group Choice (choose only one)

 TUESDAY evenings - Boca Raton (near Federal and Spanish River)
 WEDNESDAY evenings - Lighthouse Point (near Federal and Sample)
 WEDNESDAY evenings - Boca Raton **childcare** (near 18th and Powerline)
 THURSDAY evenings - Delray Beach (near I-95 and Linton)