Connection Card

We're so excited that you were touched by our service! That experience is just the beginning! There's so much more to serving you, and helping you experience God's best in your life! Complete the form below, which will allow us to connect with you to help you move forward in God's great plans for your life!

Romans 10:9-10:
That if thou shalt confess with thy mouth the Lord Jesus, and shalt believe in thine heart that God hath raised him from the dead, thou shalt be saved. For with the heart man believeth unto righteousness; and with the mouth confession is made unto salvation.

A Sinner's Prayer for Forgiveness:
Dear God, I know I'm a sinner. I know my sin deserves to be punished. I believe Christ is the Son of God, who died for me and rose from the grave. I want to turn from my sin and trust Jesus Christ alone as my Savior. Thank you for the forgiveness and everlasting life I can now have through faith in Jesus' name, Amen.

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RebirthChristian.org/PrivacyPolicy

Your name *

Email address *

Phone number *

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Gender *

Birthdate *

Household members

Are you a member of Rebirth? *

How did you hear about our church?

List the name of person who referred you to Rebirth

My Decision Today: *

I'm giving my life to Jesus

I am recommiting my life to Jesus

I want to become a member

I want to be baptized

Prayer Request, Questions, or Comments:

Check the box to download the Church Center App

The Church Center App is a great tool to keep you connected. You can register for upcoming events, check-in, give, join groups, watch Rebirth TV, access the Church Directory and more...
ALL IN ONE PLACE!