Care Card

CONNECT CARD

We believe that every person should feel loved, accepted and know they belong to a family. And so we would love you to take a moment to fill out some of your details, so we can keep in touch, and for our pastors to know how best to journey with you in your walk with God. We believe God has amazing plans for your life, and we are so excited to be on the journey with you.

Blessings in Jesus name. Ps Tony & Michelle Peak
(Please note, that all information is strictly confidential, and for pastoral purposes only at Abundant Life Centre Busselton.)

YOU

Family Name *

First Name *

Date of Birth (or birthday) *

Mobile Phone Number *

Email *

Occupation *

Residential Address *

Postal Address (if different) *

Hobbies / Interests (list as many as you like) *

Have you received Jesus? *

Water Baptism date (if applicable) *

The Holy Spirit *

YOUR SPOUSE (optional)

Spouses Family Name (if different) *

Spouses First Name *

Spouses Date of Birth (or birthday) *

Spouses Mobile Phone Number *

Spouses Email *

Spouses Occupation *

Spouses Hobbies / Interests *

Has your spouse received Jesus? *

Spouses Water Baptism date (if applicable) *

Your spouse and the Holy Spirit *

YOUR CHILDREN (optional)

First Child Name (under 18) *

First Child Date of Birth *

First Child Hobbies / Interests *

First Child - Spiritual Life *

Second Child Name (under 18) *

Second Child Date of Birth *

Second Child Hobbies / Interests *

Second Child - Spiritual Life *

Third Child Name (under 18) *

Third Child Date of Birth *

Third Child Hobbies / Interests *

Third Child - Spiritual Life *

Fourth Child Name (under 18) *

Fourth Child Date of Birth *

Fourth Child Hobbies / Interests *

Fourth Child - Spiritual Life *

Thankyou so much for taking the time to fill this out. We are looking forward to journeying with you. God bless.
Please ensure to press the SUBMIT button.

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