IBOC - Fishing Partners Registration

Registration Form
Name*

First NameLast Name
Church Name*
Church Address*

Street Address

Street Address Line 2

CityState

Zip Code
Personal Contact Number*
Format: (000) 000-0000.
Personal Email address*
Years as Pastor (Senior Pastors Only)*
T-Shirt Size*
Jacket Size*
Retreat Date: May 6, 7 & 8
Retreat Arrival Date & Time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Do you have dietary restrictions?

NoneVegetarianGluten AllergyLactose AllergyNut AllergyShellfish Allergy
Other (i.e. No White Bread, No Mayonnaise)
Please note that we only accept Visa and MasterCard.

Payment*

USDFishing Partners 2024

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Payment*

Check One$1,000 - Registration Fee OnlyOR$500 - If $1,000 is going to in any way cause a financial strain, send $500 and I'll make up the rest.
Total
Agreement*

By submitting this form, you are giving IBOC Church permission to process this transaction. All sales are final!
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