Name *

E-Mail *

Phone

Address

City / State / ZIP

It’s my ... * 1st Visit2nd VisitI’m a Regular Attender/Member

Please send me information about: Grace Kids (Birth - 5th Grade)Grace Students (6th - 12th Grade)Adult LifeGroupsGrace Powell SportsYoung Adult LifeGroupWorship TeamMissionsOther

My Next Step Today: I want to start a relationship with JesusI want to be baptizedI want to join a LifeGroupI want to become a memberI want to be part of the next Family Dedication

Prayer Request

2 + 5 = ? Please prove that you are human by solving the equation *