District Conference & Church School Registration
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
You are
Pastor
Adult Lay
Non-Pastoring Clergy
Youth (under age 18)
You are planning to particpate in
District Conference Only
Church School Convention Only
Both District Conference and Church Conference
What is the name of your church? What city? (i.e., Emmanuel, Durham)
Who is serving as pastor of your church?
Who is your church school superintendent?
Are you registering additional people? (Note: Only the Parent, guardian, or adult assuming responsibility for a minor should register minors)
Yes
No
Please give details about the people attending with you from your church
Emergency Contact Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
I, undersigned, agree with the statements selected below:
I understand that this is a mask optional event.
I uderstand that participation in any of the extra curricular physical activities that may be available is optional and at my own risk.
Date
-
Month
-
Day
Year
Date
Name of Person Completing Form
Submit
Should be Empty: