Your Name (required)
Your Email (required)
Mobile Phone Number (required)
I would like to connect with a Life Group:
Women's Life GroupN/A Men's Life GroupN/A Mixed Life GroupN/A Growing Families Life GroupN/A Impakt Youth (Yrs 5-12)N/A Young Adults (YADs)N/A
I would like to connect with some other events:
The Shed for menN/A Unique WomenN/A MESHN/A Girls' BrigadeN/A PlaytimeN/A Praise DanceN/A
I would like to connect and serve with others:
First Impressions Team
Welcoming TeamN/A Connect Desk TeamN/A
Creative Ministry Teams
Music TeamN/A Sound Desk TeamN/A Media TeamN/A Arts TeamN/A
Hospitality Teams
Kitchen TeamN/A Barista Coffee TeamN/A Food & Hospitality TeamN/A
Cleaning & Service Teams
Sunday Set Up TeamN/A Maintenance TeamN/A Mowing TeamN/A Gardening TeamN/A Cleaning TeamN/A Communion TeamN/A
Teaching Teams
Kids ChurchN/A Impakt YouthN/A Religious InstructionN/A Young AdultsN/A Life Group LeaderN/A
Other:
Digital and Marketing TeamN/A Prayer TeamN/A Pastoral Care TeamN/A Evangelical & Events TeamN/A
Is there anything else we can help you with?
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Beenleigh & District Baptist Church
Your name (Reporter of Accident/Incident) Your email Your phone number
Name of Person 1 GenderMaleFemale Telephone Date Of Birth Address DescriptionChurch MemberChildContractorStaff MemberVisitorOtherIf other, specify:
Name of Person 2 GenderMaleFemale Telephone Date Of Birth Address DescriptionChurch MemberChildContractorStaff MemberVisitorOtherIf other, specify:
Name of Person 3 GenderMaleFemale Telephone Date Of Birth Address DescriptionChurch MemberChildContractorStaff MemberVisitorOtherIf other, specify:
Accident - Incident Details
Date of Accident/Incident? Time of Accident/Incident? Location of Accident/Incident? Description of Accident/Incident Attach Drawing of Incident if available Attach Photograph 1 of Incident if available Attach Photograph 2 of Incident if available Which body parts were affected by the Accident/Incident?
List any witnesses to the Accident/Incident:
Witness Name
Address
Phone Number
Statement
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