register for connect discipleship Name * First Name Last Name Email * Phone * (###) ### #### Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Gender * Female Male Date of Birth * MM DD YYYY MINORS ONLY - Parent/Legal Guardian Full Name: Check all that apply * Take the steps to an ever-growing personal relationship with Jesus Christ and be Water Baptized Become a member of Christ the Rock Community Church Thank you!