Page 13 | Fresh Start Ministry

Name (Required)

Email Address (Required)

Your Phone Number

Prayer Requests

How can we pray for you?

My Decision Today: I want to...

Let us know if you made a decision today or if you want us to follow-up with you.

Commit my life to Jesus

Get baptized

Renew my commitment to Christ

Become a member

Join a small group

Speak with pastors

Age Group

Emergency Contact

In the event of an emergency, who do we contact? Phone number?

Birthday

Your Address

Allergies or Medical Info

What is your T-Shirt Size?

Small

Medium

Large

Extra Large

Solve 7 + 9 = ?

Fresh Start Ministry