ReGroup Registration

ReGroup Leader Form

Please fill out this informational form on the group you are leading.
This information will be used on ReGroup promotional materials and on the reveal website.

* Indicates required field

This is for a.... *

Leader(s) Name *

First

Last

Leader's Email *

Leader's Phone Number *

2nd Leaders Name (optional) *

First

Last

2nd Leader's Email *

2nd Leaders Phone Number *

If there's a 3rd leader, please just note in description.

Location (House Address, Business, Virtual, etc.) *

What day(s) of the week will group meet? *

Frequency *

Time Group Will Meet *

Group start date or are you already currently meeting? *

Material Your Group Will Cover (Optional Field. Please provide link if purchase of materials required) *

Category (Restore Group, Mom's, 50+, Young Adult, etc.) *

Short Group Description *may be edited if space is needed *

Submit