April Conference Sign up 2023

Becoming ONE Marriage Conference Registration hosted by Agape Child & Family Services, Inc.

(Friday 4/28 - 10:00am to 6:00pm; Saturday 4/29 - 9:00am to 6:00pm)
April 28th and 29th at the Highland Church of Christ

Fill out the form carefully to SIGN UP for the 2023 Marriage Conference
Husband's Name*

First NameMiddle NameLast Name
Husband's Birth Date*

MonthDayYear
Wife's Name*

First NameMiddle NameLast Name
Wife's Birth Date*

MonthDayYear
Wedding Date*

MonthDayYear
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Husband's E-mail*
example@example.com
Husband's Phone number*
Wife's E-mail*
example@example.com
Wife's Phone Number*
Referring Organization*
Are You a Pastor, Minister, Chaplain, or Serve in Ministry at a Church or Faith Based Organization?*
If Yes, Please Specify Your Role*
Husband's T-shirt Size*
Wife's T-shirt Size*
Do You have any special Meal Requirements, and if so What?*
Couple's Favorite Love Song and Artist *
By checking each box below, I AGREE to COMPLETE all the surveys to enroll in the Becoming One Program. (You and your spouse will receive three $25 gift cards for participating in the surveys and completion of the program.)*
Please Share Any Additional Information Needed
Should be Empty:

Becoming ONE Marriage Conference Registration hosted by Agape Child & Family Services, Inc.