Madison Street United Methodist Church

Please register below for your event. If you have questions please contact us.
* Denotes a required field to fill in
Full Name *
Preferred Name *
Date of Birth: Mo/Day/Year *

Gender*
Male
Female

Marital Status*
Single
Couple
Married
Widowed

Military Status*
Active Duty
Veteran
Not Applicable

Profession (e.g. Teacher, Physician, Homemaker, Retired, etc.) *

Primary Address*
Address Line 1 
Address Line 2 
City     State     Zip 

Cell Phone *
Email *
Verify Email *

Baptized*
Yes
No

Contact me about baptism*
Yes
No

Transfer from another church*
Yes
No

Name of church transferring from
City/State of church transferring from


Spouse/Partner (full name)
Preferred Name
Date of Birth: Mo/Day/Year

Gender   Clear My Answer
Male
Female

Marital Status:   Clear My Answer
Single
Couple
Married
Widowed

Military Status   Clear My Answer
Active Duty
Veteran
Not Applicable

Profession (e.g. Teacher, Physician, Homemaker, Retired, etc.)

Cell Phone
Email
Verify Email

Baptized   Clear My Answer
Yes
No

Contact me about baptism   Clear My Answer
Yes
No

Transfer from another church   Clear My Answer
Yes
No

Name of church transferring from
City/State of church transferring from 

Child 1 (full name)
Child 1 Preferred Name
Child 1 Date of Birth: Mo/Day/Year
Child 1 Cell Phone
Child 1 Email
Child 1 Gender   Clear My Answer
Male
Female
Baptized?   Clear My Answer
Yes
No
Confirmed?   Clear My Answer
Yes
No

Child 2 (full name)
Child 2 Preferred Name
Child 2 Date of Birth: Mo/Day/Year
Child 2 Cell Phone
Child 2 Email
Child 2 Gender   Clear My Answer
Male
Female
Baptized?   Clear My Answer
Yes
No
Confirmed?   Clear My Answer
Yes
No

Child 3 (full name)
Child 3 Preferred Name
Child 3 Date of Birth: Mo/Day/Year
Child 3 Cell Phone
Child 3 Email
Child 3 Gender   Clear My Answer
Male
Female
Baptized?   Clear My Answer
Yes
No
Confirmed?   Clear My Answer
Yes
No

Do you have more than three children   Clear My Answer
Yes
No

If you have more than three children, a member of our administrative staff will contact you to gather their information.  


Relatives Who Attend MSUMC? (please indicate your relationship)

Do you have family members living at your address who are choosing NOT to join at this time?  If so, please complete the information below.


Full Name
Date of Birth: Mo/Day/Year
Gender   Clear My Answer
Male
Female
Do you have more than one family member living at your address who is choosing NOT to join at this time?   Clear My Answer
Yes
No

If you have more than one person living at your address who is choosing NOT to join at this time, a member of our administrative staff will be in contact with you to gather their information.