Be-healed Conference Registration

1

Name* This field is required.

First Name

Last Name

2

Phone Number* This field is required.

Please enter a valid phone number.

3

How many people are you registering for ?* This field is required.

4

Names of other people joining you?Name, surname, age, cell no.

5

Your Group, Family Surname

6

Current Age (Please note we wont be catering for children under 13 at this stage)* This field is required.

Teenager (13yrs-18yrs)

Adult (18+)

7

What Church do you belong to? if any?

8

What is your interest for the conference?* This field is required.

I want Healing

I want to be empowered

I want the teaching

9

I would be interested to know more about the following:

Salvation

Water baptism

Baptism in the Holy Spirit

Does Jesus still heal?

Is healing for everyone?

What can block my healing?

10

Any other question(s) you would like answered at the Be-Healed Conference?

11

Dietary requirements.* This field is required.We cater for:

Normal

Keto Diet (No carbs. Low sugar)

12

Any serious food allergies? Please be specific.* This field is required.

13

Would like to be informed/ contacted for:

Marriage Conference

Healing Equip Conference

God Reliance/ Finance

Basic Concepts of Christianity

Conferences Next year

14

I would be Interested

Professional Coaching session(s) to deal with stuff

Add me to your list if a free session opens up

Other

15

I agree I cannot hold Venue, helpers, ministry or organisers responsible for any loss or damages during the conference, or for any "acts of God" as described in insurances terms. I understand, access to this conferences is reserved for ticket holders only.* This field is required.

Yes

No

16

Would you like to comment on your disagreement?