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First Name: Last Name:
At least one Email field must be filled out* Home Email: Work Email:
Stay Connected! If you attend ROC, we would really appreciate you taking a moment to update your family information below. This way we can better provide you with specifics you might be interested in.
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Update your Information** - Help us improve our communication with you by updating your information with us today! Please complete all applicable fields below. Thank you.
About You
Home Address*:
City: State: Zip*:
Home Phone (111-111-1111)*: Cell Phone:
Work Phone: Fax:
Birth Date (mm/dd/yyyy)*:	Marital Status:		Gender: Male Female
Activities Currently Involved in: (ex: choir, teacher, usher, camera, parking, prayer, children's ministry, youth, etc.)
Rest Stop (Small Group) Involved in:
ce² (Christian & Character Education) Courses Attending:
Is it OK to send informational email to you instead of using postal mail? * Yes, send informational email to my home email address Yes, send informational email to my work email address No, I would like to receive information via postal mail only

Your Spouse
Spouse's First Name: Last Name:
Home Address*:
City: State: Zip*:
Home Phone (111-111-1111)*: Cell Phone:
Work Phone: Fax:
Home E mail:
Work Email :
Birth Date (mm/dd/yyyy)*:	Marital Status:
Activities Currently Involved in: (ex: choir, teacher, usher, camera, parking, prayer, children's ministry, youth, etc.)
Rest Stop (Small Group) Involved in:
ce² (Christian & Character Education) Courses Attending:
Is it OK to send informational email to you instead of using postal mail?* Yes, send informational email to my home email address Yes, send informational email to my work email address No, I would like to receive information via postal mail only

Your Children
Child's First Name: Last Name:
Birth Date: (mm/dd/yyyy)* Gender: Male Female
Cell Phone? Email Address?
Name of School: Current Grade:
Activities Currently Involved in: (ex: ROC Kids, choir, dance, Mpact, Royal Rangers, ISM Youth, music, etc.)
Child 2
Additional Child's First Name: Last Name:
Birth Date: (mm/dd/yyyy)* Gender: Male Female
Cell Phone? Email Address?
Name of School: Current Grade:
Activities Currently Involved in: (ex: ROC Kids, choir, dance, Mpact, Royal Rangers, ISM Youth, music, etc.)
Child 3
Additional Child's First Name: Last Name:
Birth Date: (mm/dd/yyyy)* Gender: Male Female
Cell Phone? Email Address?
Name of School: Current Grade:
Activities Currently Involved in: (ex: ROC Kids, choir, dance, Mpact, Royal Rangers, ISM Youth, music, etc.)
Child 4
Additional Child's First Name: Last Name:
Birth Date: (mm/dd/yyyy)* Gender: Male Female
Cell Phone? Email Address?
Name of School: Current Grade:
Activities Currently Involved in: (ex: ROC Kids, choir, dance, Mpact, Royal Rangers, ISM Youth, music, etc.)
Note: If you have more than four (4) children, please submit a second form with your first and last name, and additional children’s information.

Directory and Photos
ROC Directory: We will be publishing a church directory that will provided to church members. If you have privacy concerns you may check any of the following items you would like omitted from the directory. (No children's information, other than names, will be published in the church directory.) Home Address Home Phone Cell Phone Work Phone Home Email Work Email Fax
Individual and/or family photo: Join our catalog of faces! To submit a photo, simply attach the file to an email and send it to . Or, get your picture taken by Wayne Remines, ROC photographer, in the foyer after service. (Note: He will not be available every Sunday)

Submit Form*
Click 'Submit' below, to: Sign up for Email Update your Information Thank you!

* Denotes required fields. (Required fields for Your Spouse and Your Children apply only if you are married and/or have children.)

** Personal Privacy Policy: We have a concern for your privacy, and would like to assure you that we are collecting information for record keeping and communication purposes only. We want to encourage individuals within the ROC Community to fill out all applicable fields, noting we will not be selling or distributing personal information to any company. We will, however, be publishing a church directory that will be provided to church members. You have the opportunity to specify (on this form) which items you do not want published in the directory.

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