Thank you for your interest in registering with Jericho Road Church! At this time, all accounts being created need to be approved before being activated. This is to help us ensure that we get to know you in person, and not just as an account name. Please fill out the registration form as completely as possible, and allow us up to 48 hours to approve your account.

Thank you!

-Jericho Road Church Technology Team

Account information

Username: *

Spaces are allowed; punctuation is not allowed except for periods, hyphens, and underscores.

E-mail address: *

A valid e-mail address. All e-mails from the system will be sent to this address. The e-mail address is not made public and will only be used if you wish to receive a new password or wish to receive certain news or notifications by e-mail.

Apply for role

Select a role or roles:

children/youth ministry team

equipping team

hospitality team

member

mission team

partner

prayer team

stewardship team

worship team

Address

Street:

Please enter your home address (address and street name).  The content of this field is kept private and will not be shown publicly.

Unit/Apartment #:

 Please enter your unit or apartment number, if applicable. The content of this field is kept private and will not be shown publicly.

City: *

Please enter the name of the city where you live. The content of this field is kept private and will not be shown publicly.

State: * ALAKAZARCACOCTDEFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY

Please select the state where you live. The content of this field is kept private and will not be shown publicly.

Zip Code:

  The content of this field is kept private and will not be shown publicly.

Children Information

First Child:

Please enter the first and last name of your oldest child, if applicable.  The content of this field is kept private and will not be shown publicly.

Second Child:

Please enter the first and last name of your second child, if applicable.  The content of this field is kept private and will not be shown publicly.

Third Child:

Please enter the first and last name of your third child, if applicable.  The content of this field is kept private and will not be shown publicly.

Fourth Child:

The content of this field is kept private and will not be shown publicly.

Contact Information

Home Phone #:

Please enter your home phone number, if applicable. The content of this field is kept private and will not be shown publicly.

Family Information

Family Last Name: *

Please enter the last name you'd like to use for your family.  The content of this field is kept private and will not be shown publicly.

First Full Name: *

Provide the first and last name of the first family member. The content of this field is kept private and will not be shown publicly.

Main Mobile:

Mobile phone number of the first family member. The content of this field is kept private and will not be shown publicly.

Spouse's Full Name:

Enter the first and last name of your spouse, if applicable.  The content of this field is kept private and will not be shown publicly.

Spouse's Mobile:

Please enter the mobile number for your spouse, if applicable.  The content of this field is kept private and will not be shown publicly.

Spouse's Email:

Please enter the email address of your spouse, if applicable.  The content of this field is kept private and will not be shown publicly.