Mount Lassen Community Church

Connect Card

Welcome to our church! We're glad you're here. Our team would love to serve you and help you get connected.

First Name

Last Name

Spouse's Name

Spouse's Last Name

Email

Phone

Address 1

Address 2

Country

City

State

Zip/Postal Code

Children & Ages

How many times have you visited our church?
This is my first time
A few times
Regular attender

I would like to learn more about (check all that apply):
Baptism
Volunteering
Membership
Small Groups
I would like to talk to a pastor

Did You --
Dedicate your life to Christ for the first time?
Re-dedicate your life to Christ?

How did you hear about us?

Prayer Requests or Questions