r5 Final Registration

Identify your paid registration *

Name of person attending r5 *

First Name Last Name

Email *

example@example.com

Check all that apply *

Phone Number *

Please enter a valid phone number.

Church *

Pastor *

City State *

What are some areas of challenge during this season? (Youth Ministry) *

What do you hope to learn at the r5 retreat? *

Video, Picture, Interview Participation Release

Portions or all of the r5 retreat conference will be video taped. The use of the footage will be up to the descretion of it's producers. ABA Ministries, Alphaeus Anderson separately and/or collectively, have the right to use my picture, silhouette and other reproductions of likeness, performance, interview and voice in connection with the promotion of ABA Ministry and Gain Maintain for educational purposes, media material promoting in any packaged recordings produced by ABA Ministries and Gain Maintain.

ABA Ministry & Gain Maintain shall have all rights, title and interest in any all results and proceeds from said recordings, advertisement’s images or appearance. Rights are perpetual and include the use of any and all interviews, performances, recordings in any medium, pictures or images.

Signature that I have read and understand the media release. *

Clear

Thanks registering for r5. Finalize registration by completing form.