Student LifeGroup Sign-Up

We are glad that you would like to get connected with a LifeGroup! Please fill out the information below and someone will be in contact with you to get you connected! If you are already assigned to a group, that's great! You do not need to fill out this form again each year. 

*Address Line 1
Address Line 2
*City
*State/Province/Region
*Zip/Postal Code
Please list the one friend you would most desire to be in a LifeGroup with:
*Gender
*Birthdate
*What school do you attend?
*Grade
Student Email Address
Student Cell Phone #
*Parent Name(s)
*Parent Cell #(s)
*Parent Email Address(es)
Does your student have any dietary allergies/restrictions?
Does your student have any medical conditions that you think we should be aware of?