First Time User Registration:

Username (optional)
Password (optional)

Please enter your name and email address here. This information will be kept strictly private. Note that the * means a required field.

* First Name
* Last Name
  Address 1
  Address 2
  Postal Code

* Email Address

 ()   - Phone Number

(Optional) You can be contacted by cell phone text messaging.
If so desired, please enter Cell Phone and Carrier:

() - Cell Phone
(Optional) Cell Phone Carrier:

Do Not Send Text Messages


Person Gender

    Birth Date

    Wedding Anniversary

Allergy/Special Need Instructions (140 char limit):

Allergy/Special Need Instructions (details):

Personal Mailing Name
Family Mailing Name

Additional Information < Expand/Close

Other Information:

(Optional:) Upload a photo for your personal page

Prayer Wall Setup Options:

NOT receive an alert notification via e-mail whenever postings and replies are made to the member's Prayer Wall.
NOT receive cellphone texts when messages are added to the prayer postings.
NOT included in automatic phone broadcasting notifications?

Photo Directory Options:

Include My Address
Include My Email
Include My Photo
Include My Phone
Include My Cell Phone

Personal Data about this Person

   I am available for Weekends this Year?
* Enter Name of person entering this registration information
* Enter Name of Person Who Encouraged You to Register
   Your Approximate Age Range?
   Enter First Name of Spouse
* My First Choice or Preferred Team Member Position
* My Second Preferred Team Member Position
   I have served previously in the following Team Positions
   Have you served as a team member before? If yes, approximate year?
   Have you served as a team member recently? If yes, what was the coordinator name?
   Has your home church experienced a Renewal Weekend? If yes, approximate year?
   Approximate number of Renenwal Weekends you want to serve each year?
   Are you able to travel for weekends out of your state? If so, what distance or milage?
   Any Special Housing Needs? If Yes, Please Describe
   Enter the Name of the Church where You are a Member
   Enter the City & State of Your Home Church Membership
   Enter the Name of Your Pastor
* Participate in a State Prayer Group
-No Change-
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Prayer Group - MD
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Prayer Group - MI
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Prayer Group - MS
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Prayer Group - ND
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Prayer Group - NH
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Prayer Group - OK
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Prayer Group - SD
Prayer Group - TN
Prayer Group - TX
Prayer Group - UT
Prayer Group - VA
Prayer Group - VT
Prayer Group - WA
Prayer Group - WI
Prayer Group - WV
Prayer Group - WY
   Emergency Contact Phone Number for You?
   Enter the Name of Your Emergency Contact
   What is Your Relationship to Your Emergency Contact?
   Have You Submitted a Request for CRJ Background Check?
   Get Background Check - See Choices Here:
   We are requesting ALL CRJ Team Members to have a CRJ Background Check at this LINK




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