Connect Card

Welcome to Bayou Blue Assembly! We are honored that you chose to worship with us. Help us connect with you by telling us a little bit about yourself!

First Name

Last Name

Birthdate

Phone Number

Address

Apartment, suite, etc.

City

State

Postal / Zip Code

Marital Status

Spouse's Name

Birthdate

Spouse's Email

Spouse's Phone Number

Do you have any children?

Yes

Child's Name

Gender

Birthdate

Allergies

Add another child?

Yes

Second Child's Name

Gender

Birthdate

Allergies

Add another child?

Yes

Third Child's Name

Gender

Birthdate

Allergies

Add another child?

Yes

Fourth Child's Name

Gender

Birthdate

Allergies

Add another child?

Yes

Fifth Child's Name

Gender

Birthdate

Allergies

How did you hear about us?

Anything else you'd like to share?

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