Adult Ministry Registration Form

Thanks for your interest in the Adult Ministry at Peace Lutheran Church! Please fill out of the following information and we will be in touch with you soon.

Which adult ministry program are you registering for?

Registrant Information

Information for the person registering for this program.

Please enter your first and last name.

Please enter your street address.

Please enter your city of residence.

Please select your state of residence.

Please enter your 5 digit zip code.

Please enter your phone number with area code like ###-###-####.

Please enter your email address.

Please enter your preferred method of contact.

Are you a member of Peace Lutheran Church?

Photography Waiver

By entering your initials in the box below, you hereby grant Peace Lutheran Church leaders permission to photograph/film the minor(s) designated above in any manner or form for any lawful purpose associated with this Peace Lutheran Church program.

Please enter your initials in this box to signify agreement with the above photo waiver.

Use this area for anything else you would like to tell us.

CAPTCHA
This question is for testing whether you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.