Student Life Group • Southern Hills

First Name *

Last Name *

Gender *

Date of Birth *

Mobile Number

Email Address

School Grade *

School *

Emergency Contact Name *

Emergency Contact Number *

Emergency Contact E-Mail

Have you ever been in a SoHills Life Group before?

Yes.

No. Let's do this!

What interests do you have?

Name 3 people you know at the 78 or 912.