small group registration form

Name: 

Address: 

City:    State:    Zip Code: 

Home Phone:    When is the best time to reach you at home? 

Cell Phone:    May we contact you on your cell phone?  Yes  No

Work Phone:    May we contact you at work?  Yes  No

Email Address: 

I would like to register for:  GroupLink event (Sunday, January 11, 5-7 pm)  Starting Point (second session beginning January 11, 10:45 am - noon)

How did you hear about CFC Small Groups:  PosterBulletinWebsiteOtherFriend     Age Group:  20-2930-3940-4950-6464+     Gender:  MaleFemale

I would prefer to meet on (please check all that apply): 
          Monday
          Tuesday
          Wednesday
          Thursday
          Friday
          Saturday
          Sunday

If you have children, what are they're ages?  (Please check all that apply.)
          No children
          Infant
          Toddler
          Elementary
          Junior High/High School
          College
          Empty-Nester

Additional comments or questions (including information that would help in your small group placement):