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Harvest Church Encounter Registration Form
Encounter Type
Men
Women
Leaders
Youth
Couples
Encounter Date (DD/MM/YYYY)
Encounter Venue
Full Name
Address
Post Code
E-Mail Address
Telephone Number
Daytime Telephone Number
Mobile Telephone Number
Age Group
12-15
16-20
21-29
30-39
40-49
50-59
60+
Do you require transport? (coach)
No
Yes
Would you be driving?
No
Yes
Would you be willing to give a lift to someone who would share the petrol costs?
N/A
No
Yes
Next of Kin's Name
Relationship to You
Next of Kin's Address
Next of Kin's Post Code
Next of Kin's Daytime Telephone Number
Next of Kin's Evening Telephone Number
Next of Kin's Mobile Telephone Number
Have you been water baptised?
No
Yes
If yes, what denomination?
Were you an infant or adult?
N/A
Infant
Adult
Is this your 1st Encounter?
No
Yes
Do you belong to a cell group?
No
Yes
Have you completed the Pre-Encounter?
No
Yes
Name of your Primary G12 Leader
Name of your Cell Leader
Contact Number of your Cell Leader
Name of Church
Name of Pastor
Any special dietary requirements?
