Name *

First Name

Last Name

Phone *

(###)

###

####

Birthdate

MM

DD

YYYY

Checkbox

Regular Attender

First or Second-Time Guest

What are you interested in?

Today I made a decision to follow Jesus

I would like to know more about Kelso Christian Assembly

I would like to serve in a ministry (Kids, Youth, Cafe, Media, Worship, Welcome Team, etc.)

I would like to know more about baptism

I would like to join a KCA Group

Other