Lifeway Communicator Card

lifeway cONNECT card

Are you a... *

Member Regular Attender Guest/Visitor

* Indicates required field

Name *

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Last

Your Phone Number *

I would like to be contacted by: *

Text Phone call Email

Spouse Name *

First

Last

Spouse Phone Number *

I would like to be contacted by *

Text Phone call Email

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

1. Child's Name & Age *

4 Child's Name & Age *

2 Child's Name & Age *

5 Child's Name & Age *

3 Child name & Age *

6 Child's Name & Age *

Event Name *

Number Attending *

I'm interested in: (select one from list) *

Prayer Requests/Praise Reports *

Note to the Pastor *

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