Synod 2025 Registration Form

Synod 2025 Registration Form

"Ancient Wells for a thirsty world"
Primary Registrant Name*

First NameLast Name
Salutation
Mobile Phone
Please enter a valid phone number.
Email*
example@example.com
Diocese
Your Name Badge
How do you prefer your name to appear
Registration Type*
Spouse's Name
Spouse's Name Badge
How does your spouse prefer their name to appear
Willing to share hotel room?
Interested in sharing a room and splitting the costs with your roommate?
Number of Delegates from your church?
Minimum of 4
CHURCH delegate fee
NOTE:
The maximum number of delegates that can be automatically registered via a single form is 4.

Since you have indicated that your church will be registering {numberOf} delegates, the General Secretary's office will contact you to obtain delegate information after your payment is processed.
Church Delegate 1
Name Badge Delegate 1
Church Delegate 2
Name Badge Delegate 2
Church Delegate 3
Name Badge Delegate 3
This is my first CEEC event:

TrueFalse
Mobility Restrictions
Dietary Restrictions
Synod Paid Date

MonthDayYear
Date
Synod # Registered
Synod Total Fee
CALCULATED FINAL PRICE

Registration Fee:*

USDTotal Registration Fee

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