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  • First Name REQUIRED Please fill out this field. Please enter valid data.

    Last Name REQUIRED Please fill out this field. Please enter valid data.
  • Age Group (used for determining group assignments) REQUIRED (Select One) 30 and other 31 - 50 51 - 65 Over 65 Please fill out this field.
  • Phone Number REQUIRED Maximum 20 characters Please fill out this field. Please enter a phone number.
  • Email REQUIRED Please fill out this field. Please enter an email address.
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    • Cell Phone Number (Required if text is selected) Please enter valid data.
  • Others you would like in your group (we will try to honor preferences)
  • Where was following Christ completed REQUIRED Please fill out this field. Please enter valid data.
  • Where was discovering Christ completed REQUIRED Please fill out this field. Please enter valid data.

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