Join/Register a Life Group *

First Name *

Last Name *

Location of Group (e.g. Langwarrin) *

What location(s) would you prefer? (e.g. Langwarrin) *

Mobile Number *

Email Address *

What time will the group run? (e.g. 7pm) *

What time would you prefer? *

Who will be attending the group? *

Which day(s) would you prefer? * MondayTuesdayWednesdayThursdayFridaySaturdaySunday

Any other comments