INFORMATION | Vida A/G Church

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 a pastor

Age Group

Emergency Contact

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

Allergies or Medical Info

What is your T-Shirt Size?

Small

Medium

Large

Extra Large

Birthday

Your Address

Vida A/G Church