Membership Interest Form

Ready to Live? Fill out the form below, and a member of our team will reach out to welcome you home.

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

Birthday

*

Gender

*

Please select one option.

Male Female

Marital Status

*

Please select one option.

Single Married Separated Married Widowed

Contact Preference

*

Please select one option.

Phone Email Text

Preferred Name (if different from first name):

If married, please input your wedding date:

Do you have children?

*

Please select one option.

Yes No

Medical

Do you have any medical conditions or allergies that you would like us to be aware about?

*

Emergency Contact

*

Children's Information

Name

Gender

Please select one option.

Male Female

Birthday

Name

Gender

Please select one option.

Male Female

Birthday

Name

Gender

Please select one option.

Male Female

Birthday

Additional Children

Any medical conditions or allergies?

Growth & Engagement

How were you introduced to The L.I.V.E. Church

*

Please select one option.

Family/Friends Social Media Walking/Driving By Community Outreach Web Search

Have you accepted Jesus Christ into your life as your Lord & Savior?

*

Please select one option.

Yes No

Have you been baptized?

*

Please select one option.

Yes Yes, but I am interested in being baptized again. No No, but I am interested in getting baptized.

Which areas are you passionate about?

*

Please select all that apply.

Worship & Arts Media & Tech Community Outreach Youth & Children's Ministry Hospitality & Greeters

What was it about the service or the ministry that made you want to take this step today?

*

Is there anything specific we can pray for you about as you join this family?

Today's Date

*

Description

Ready to Live? Fill out the form below, and a member of our team will reach out to welcome you home.

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