Personal Details

Name *

(Your full name, including first name and surname)

First name *

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Middle name(s)

Surname *

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Email Address *

(A valid email address that we can reach you on)

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Telephone No.

(A mobile or landline telephone no. that we could reach you on)

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Date Of Birth

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Gender *

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Date First Visited LCC (in person or online) *

(Either in person at our Church Centre, or online via our Facebook Page or website)

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New Guest?

Are you a new guest? (If you're new to Life Community Church, mark it here so we can send you a note to thank you for joining us and to share about what's available to you.)

I'm New

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My Decision Today

My Decision Today: *

(Please choose any of the options that apply today)

I am committing my life to Jesus

I am recommitting my life to Jesus

I want to be baptised in water

I would like someone from the Pastoral Team to reach out to me

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My Next Step

I am interested in learning more about:

(Please choose any of the options that apply today)

Small Groups

Growth Track

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Thank you for completing this form. One of our team members will be in touch with you soon! All of your information will be stored securely, and by clicking "Submit", you are agreeing to our Privacy Policy (visit: https://life-cc.org/privacy-policy).