Kies 'n Kleingroep/ Choose a Small group 
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Kies 'n Kleingroep/ Choose a group *
Required
Naam/ Name *
Van/Surname *
Selfoon nr/ Mobile no.: *
Eposadres/ Email address *
Geboortedatum/ Date of birth *
MM
/
DD
/
YYYY
Geslag/ Gender *
Required
Is jy 'n lid van Veranderde Lewens Gemeente?
Are you a member of Veranderde Lewens Gemeente?
*
Indien jy kinders het, sal jy hulle wil saam bring?
If you have children, would you like to bring them along?
Enige addisionele inligting/  Any additional information
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