Register/Update Details 18+ • Grace Bible Church Holland Park

This form applies to you if you are 18 years of age or older.

Please complete all sections that are applicable to you.

If you have a spouse who also attends Grace Bible Church, please click Add Another 18+ Person at the end of the form.

If not, please click Submit.

All information provided is private and confidential

Personal Information

Last Name *

First *

Preferred Name *

Middle Name *

Tip: If you have a middle name we require you to fill it in please IF NOT then please write n/a

Date of Birth *

Gender *

Marital Status *

MOBILE Number

HOME Phone Number

Email Address *

Home Address *

Suburb *

Postcode *

Mailing Address *

Suburb *

Postcode *

Attend Date

Tip: Date you first attended GBC if you remember. Even month and year is good.

Allergies

Allergy Details

Allergy Reaction

Severe (Anaphylaxis)

Moderate

Mild

None or N/A

Other Medical Conditions

Family Doctor Name and Phone

Emergency Contact *

I would like to join the following group - please list the name of the group in the box below and we will add you!

I give permission for my contact details to be stored/updated in Elvanto (our church software management system). *

Yes please

No thank you

Locations

Holland Park

Corinda

Springwood

Thornlands

Not a GBC Network member/attendee

Only if applicable:

I give my permission to be added to the Friday night church family news email.

Yes please

No thank you

I would like to become a regular attendee or member

Yes please

No thank you

I would like to become a member - please send me Membership class details.

Yes please

No thank you

I am no longer attending please remove me from the system.

Yes please

No thank you

Comments or feedback