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?

Resource Links

Harvest Church Encounter Registration Form