Pastor Spouse Retreat Payment
Please submit payment AFTER filling out the registration form.
Name of Person Filling Out this Form
*
First Name
Last Name
Local Church
*
E-mail
*
example@example.com
Please list all participants being paid for:
*
Select Registration Type(s):
*
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Pastor Spouse Retreat Single
$
350.00
Quantity
1
2
3
4
5
6
7
8
9
10
Pastor Spouse Retreat Couple
$
450.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit Payment
Should be Empty: