Emerge 2020 Registration Form

EMERGE: Laying Aside the Pain of 2020 Looking Ahead to the Promise of 2021

ADULT: Please complete this form to register yourself and/or your household for the appropriate EMERGE session(s). Please complete only one (1) form per household. 🖊 Please note: A student may participate in this event, even if an adult in the household does not. However, a parent or legal guardian must give consent to their participation by completing this form on the student's behalf.
Full Name (adult)

First NameLast Name
Full Name (adult)

First NameLast Name
Full Name (adult)

First NameLast Name
Full Name (student)

First NameLast NameGrade
Full Name (student)

First NameLast NameGrade
Full Name (student)

First NameLast NameGrade
Full Name (student)

First NameLast NameGrade
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
Number of adults attending
Number of intermediate/middle students (grades 5-9) attending
Number of high school students (grades 10-12) attending
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
My Products
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Group 1 & Group 2 Students (grades 5-9); 2-3:30 pm
$5.00 Quantity



Group 3 Students (grades 10-12); 2-3:30 pm
$10.00 Quantity



Adults; 4-5:30 pm
$20.00 Quantity



Total

$0.00
The joy of the Lord is our strength.

For more information, contact: info@cornerstone525.org
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EMERGE: Laying Aside the Pain of 2020 Looking Ahead to the Promise of 2021

My Products

Pay with PayPal