Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

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Spouse's Name (if applicable)

First Name

Last Name

Spouse's Phone (if applicable)

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Did you make a decision that you would like us to know about?

I am commiting my life to Christ

I desire to be baptized

I am renewing my commitment to Christ

I desire to become a member of Crossroad

I would like more information on:

How to begin a relationship with Jesus

How to join this church family

I would like to speak with one of the pastors

Sunday School

Crossroad Kids

Crossroad Student Ministry

The Men's Ministry

The Women's Ministry

How to join the Praise Band

The Missions Ministry

How to serve with the Coffee Ministry