Name *

First Name

Last Name

Phone *

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birthday *

MM

DD

YYYY

Are you a member of another local church? *

Yes

No

Do you have any children? *

Yes

No

I am open to receive instruction and correction from Pastors Paul & Brooke Capehart and/or the leadership specifically assigned to minister on behalf of Harvest Family Church. *

I am willing, if called upon, to be personally interviewed prior to acceptance of my membership application. *

By becoming a member of Harvest Family Church at Cypress, TX, I understand that I am making Harvest Family my home church. Further, I am committed to being a faithful prayer partner, a regular tither, and am willing to serve on the Dream Team. *

I have read and do agree with the statement of faith of Harvest Family Church. Further, I understand that as a member of Harvest Family Church, I do not have voting or reporting rights in the non-profit organization. *

Background Check *

Our Church Policy & Insurance requires that we have a current background check performed on every individual that volunteers & Serves at Harvest Family Church. Background Check. I authorize the complete release of these records or data pertaining to me which an individual, company, firm, corporation, institution, school or university, law enforcement or public agency may have. I authorize the full release of the information described above, without any reservation, throughout any duration of my employment at the Company. I release all persons or entities from liability from any alleged damage that may result from furnishing accurate information in good faith to the company. I certify that all information provided below is true and accurate to the best of my knowledge. This authorization and consent shall be valid in original, facsimile (“fax"), or copy form. The following information is required by law enforcement agencies and other entities for identification purposes when checking records. It is confidential and will not be used for any other purpose.