If you consider CityLife Church to be your home church, then please complete and submit the form below. The details that you provide will enable us to know how/where to contact you and will assist us in providing pastoral care and in managing involvement in church ministries. View a full version of our Privacy Policy.

In submitting this form, are you: *


First Name *

Surname *

Parent's Names *

Parent's Surname *

Your Gender

Date of Birth
/ /
Country of Birth
Street Address
Suburb
Postcode
Home Phone
Mobile Phone
Email *

Previous Church
Date you began regularly attending Epic Youth
Name of School
School Year level
Life Group Leader's Name
Do you come to CityLife on the weekends?

Do your parents attend CityLife Church?

Do they support you attending?

Do you live at home with:
Which Congregation do you primarily attend?

Is there any information, medical or otherwise, which would help the Youth Leader?
Additional Comments


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