Connect Card (Adelaide) • LifeHouse Church

Please fill in your details first, then add any additional family members who will also attend LifeHouse

First Name *

Last Name *

Date of Birth

Gender *

Marital Status

Reason for filling this in today *

How Did You Hear About LifeHouse?

Lifehouse Campus

Please indicate how you are connected to Lifehouse - one of our physical campuses or if you are an online only viewer.

Locations

Westmeadows

Online

Poznan

Adelaide

Mobile Number

Email Address

Address

Suburb

State

Postcode

Please complete for each child you enter.

School Grade (if applicable)

Do you consent for your child to be photographed or filmed

No

Yes

Tip: Photography and film is used for promotional purposes on LifeHouse social media, website and video clips.

Medical Information

Tip: Please complete if there is anything we need to be aware of for your child, eg allergies etc