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PREREGISTRATION FOR ALUMNI
Name: Male Female
Address:
City: State: Zip Code:
Home Phone:
Cell Phone:
Work Phone:
Fax:
Email Address:
May we call you at work? Yes No
Church member? Yes Where?
Would you like more information about this church? Yes No
If provided, would you need child care? Yes No
FP4H member kit $84.00 each
Bible study book $16.00 each
Both resources $100.00
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Please carefully read the following statement:
I understand the commitments of the first place 4 health program and have participated in at least one session.
I have prayerfully considered my desire to continue in first place 4 health and believe God truly is leading me to recommit myself to the four sided person program.
I understand that the information I will receive in the first place 4 health program is intended to be solely informational and educational. I realize that first place 4 health encourages participants to consult with their physicians before starting this program.
If for any unforeseen reason I have to withdraw from the first place 4 health program, I agree to notify my leader and discuss the matter with prayerful consideration.
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Signed: Date:
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