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To register for this web site, complete the form. Your details will be passed to the site administrator who will then review your application.

Registration Form

Firstname*:
Surname*:
Email*:
Re-enter email*:
Male / Female*:
Male
Female
Date of Birth :
(DD/MM/YYYY)
Address*:
Telephone number*:
Spouse/Partners name (if applicable) Please include surname if different from your own.:
Childrens' names and dates of birth (if applicable):
Which Thameshead Benefice church(es) do you regularly attend?*:
How often do you attend this/these church(es)?*:
Are you on the Electoral Roll of this church or any other? Please state which.*:
Do you belong to any church groups? e.g PCC Small Gp Messy Church Team etc. Please state which ones.*:
Do you have difficulty accessing church e.g Mobility/hearing difficulties? Please explain:
Would it help if church services were held elsewhere. e.g. Village Hall, Communion in your own home?:
Please enter the verification number on the right:*
four four three six two
I have read and agreed to the terms and conditions
*required fields