Harrisburg Baptist Church

Connect Card

Welcome to Harrisburg! We're glad you're here. Our team would love to serve you and help you get connected.

First Name

Last Name

Date of Birth

Email

Phone

Address 1

Address 2

Country

City

State

Zip/Postal Code

Marital Status
Single
Married
Widowed
Divorced

Spouse's Name

Children's Names

How many times have you visited our church?
This is my first time
A few times
Regular attender

How did you hear about us?

How can we pray for you?

Anything else you'd like to share?