Name

First Name

Last Name

Phone

(###)

###

####

I Am

New to Summit Grove Community of Christ

New Follower of Christ

Regular Attender

I Would Like *

Please check all that apply. Note if you would like to be contacted make sure you fill out the contact information in full.

My Prayer or Concern to Remain Private

To Be Added to the Prayer Chain

To Be Contacted By a Minister or Church Representative