Crosspointe - Register with Crosspointe!

Site Registration

Thank you for joining Crosspointe!
Please complete the application below. Once you have done so, click the Register Now button to
send your information to us. We will process your application as soon as possible.

(*=required field)

*Username:** Name to be used when accessing this site
*Email Address:** Valid email address
*Confirm Email Address:** Confirm Valid email address
Prefix: Your Prefix:
*First Name:** Your First Name
*Last Name:** Your Last Name
List other adults: Other adults in the home
Children and Birthdates: List children (if any) and birthdates
Include child information in our members only online directory, printed directory only, both, or neither?: Your directory status	Online Printed Both Neither

*Phone:** Your home phone number
Mobile Phone: Your Mobile Phone Number
Business Phone: Your Business Phone Number
Emergency Contact: The person to contact in case of an emergency
Relationship: Your relationship to the contact person
Phone: The phone of the contact person

*House Number:** The number of your house
*Street Name:** The name of your street

*City:** Your City
*State:** Your State:
*Zipcode:** Your Zipcode

*Are you a resident, associate or neither:** Click the appropriate option	Resident Associate Neither
*Do you agree with and accept our site Terms of Use?:** Select the appropriate response	No Yes