Conference Registration Form with Payment

Rekindle Conference Registration

Please register by completing the form below, and submitting your payment at the bottom of the page.
Full Name*

Husband & Wife First NameLast Name
E-mail*
example@example.com
Phone Number*
Format: (000) 000-0000.
Number of people attending*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Church I Attend

Church NameCity
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
My Products
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Conference Full-Access (BOTH Husband & Wife)
This covers materials and refreshments for 1 married COUPLE, for the entire conference (Fri & Sat)

$40.00

Conference Full-Access (ONLY Husband or Wife)
This covers materials and refreshments for ONLY 1 married PERSON, for the entire conference (Fri & Sat)

$25.00

Total

$0.00
Should be Empty:

Rekindle Conference Registration