Eastern & Southern States Council 2025 Winter Conference

Eastern & Southern States Council 2025 Winter Conference

Jan 30 - Feb 1, 2025
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Email Address*
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Billing Name*

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Billing Address*

Street Address

Street Address Line 2

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Zip Code
Phone Number*
Name of Home Church*
Pastor's Name*

First NameLast Name
Adult Registration @ $25.00 Each
Please enter the first and last name of each person you are registering. After entering the first one hit save and then enter the second and so on... If your are registering for yourself only please enter your first and last name and hit save. After entering all the persons you are registering continue with the rest of the registration form. The form is not complete until you submit for payment.
Please enter the First & Last Name of each ADULT being registered then hit "Click to add name"*
IMPORTANT: Please hit the "Add Name" button above ONLY after entering each name then continue with the registraton below
ESSC Adult Total @ $25.00 each.
Registration Ages 14 -17 @ $10.00 Each
Please enter the first and last name of each person you are registering for this age group (14-17). After entering the first one hit save and then enter the second and so on... If your are registering for yourself only please enter your first and last name and hit save. After entering all the persons you are registering continue with the rest of the registration form. The form is not complete until you submit for payment.
Please enter the First & Last Name of each teen (14-17) being registered then hit "Click to add name
IMPORTANT: Please hit the "Add Name" button above ONLY after entering each name then continue with the registraton below
ESSC Person ages 14-17 Total @ $10.00 each.
Registration Ages 7 -13 @ $5.00 Each
Please enter the first and last name of each person you are registering for this age group (7-13). After entering the first one hit save and then enter the second and so on... If your are registering for yourself only please enter your first and last name and hit save. After entering all the persons you are registering continue with the rest of the registration form. The form is not complete until you submit for payment.
Please enter the First & Last Name of each child (7-13) being registered then hit "Click to add name
IMPORTANT: Please hit the "Add Name" button above ONLY after entering each name then continue with the registraton below
ESSC child ages 7-13 Total @ $5.00 each.
Total Amount of Registrations
Today's Date*

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Please Note: We use Paypal as our payment processor. A Paypal account is not required. All major credit cards are accepted
Total Amount Charged

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