Church Directory Update

Please enter current contact information for you and your household and note which information you give permission to be published in our online and print directories.

*Please note that every person 18 years old and older must submit their own contact information and signature in order to be included in the published directory.

Name

This address will receive a confirmation email

Home Phone

Mobile Phone

Address

Additional Household Members

Spouse's Name

Please provide mobile phone numbers and email addresses for additional household members if different than those entered above.

Child/Children

Other Members of Your Household

Permissions

Please mark which information may be published in our Church Directory, both online (Breeze) and in print form. Please note that by giving Crossroads Christian Church permission to include your information, you are acknowledging that your information will be made available to others who attend and/or are members of the church.

Mark all that apply:

Please select all that apply.

All None Name Home Address Home Phone Mobile Phone Email address Spouse's Mobile Phone Spouse's Email Address Child's/Children's Mobile Phone Child's/Children's Email Address Other Household Member's Mobile Phone Other Household Member's Email Address

ELECTRONIC SIGNATURE
Please type your name into the space below to give your permission for the above information to be published in the Crossroads Christian Church directory

Electronic Signature

Church Directory Update

Description

Please Fix the Following