Green Valley Baptist Church
We are updating our church database and would like to verify the contact information for everyone in our church. Thank you for taking the time to give us an update!

Please give us a call in the church office (702-434-1906), if you have any questions about this form. The office is open Monday-Thursday from 8:00am - 4:30pm.

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PRIMARY First & Last Name (Head of Household) *
PRIMARY Date of Birth *
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PRIMARY Marital Status *
PRIMARY: Are you a member of GVBC? *
PRIMARY: Are you a regular attender of GVBC? *
PRIMARY Mobile Phone Number *
PRIMARY Home Phone Number (if applicable)
PRIMARY Email Address *
Household Address (complete with street, apt or unit #, city, state and zip code) *
SPOUSE First & Last Name
SPOUSE Date of Birth
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SPOUSE: Are you a member of GVBC?
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SPOUSE: Are you a regular attender of GVBC?
Clear selection
SPOUSE Mobile Phone Number
SPOUSE Email Address
CHILD #1 First & Last Name
CHILD #1 Date of Birth
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CHILD #2 First & Last Name
CHILD #2 Date of Birth
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YYYY
CHILD #3 First & Last Name
CHILD #3 Date of Birth
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YYYY
CHILD #4 First & Last Name
CHILD #4 Date of Birth
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YYYY
CHILD #5 First & Last Name
CHILD #5 Date of Birth
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YYYY
CHILD #6 First & Last Name
CHILD #6 Date of Birth
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YYYY
CHILD #7 First & Last Name
CHILD #7 Date of Birth
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YYYY
CHILD #8 First & Last Name
CHILD #8 Date of Birth
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