Potter's Mark Fellowship Registration

Please register for The Potter's Mark Women's Conference here. One submitted form equals one registration. If you are coming with a group, each member needs to fill out and submit a form. Forward any questions to alyssa.pool@upwardboundyouth.org. We are so excited to have you joining us!

Name*

First NameLast Name

Email*

example@example.com

Your Age Range*

Your Phone Number *

Emergency Contact Number *

Emergency Contact Name and Relationship *

Choose THREE breakout sessions you would like to attend. Please keep in mind that you will only be attending two and sessions have capacity limits so first come first serve!*

Hope in the Darkness: Navigating Anxiety, Depression, and SuicideMotherhood: Keeping Christ at The Center of it AllWalking in Forgiveness: A Session on Trauma and How to Forgive OthersWhy Am I Single?Spiritual DisciplinesNaming The Lies

During free time on Saturday, we will have a water color painting class! There is limited space, but if you do not want to participate in outdoor activities feel free to join the water color class! Please specify below if you would like to participate in the painting class.*

I would like to attend the painting class!No, thank you! I would like to participate in the outdoor activities during free time!

Do you have any dietary restrictions? Please include any allergies and dietary restrictions you may have and that we should be aware of.

How did you hear about this conference?*

Rooms will be dorm style and we would love to keep groups together! If you have roommate requests, please list them below. Please keep in mind we have limited rooms and beds so first come first serve! Included in your answer, please list their full name. Also, if you would have trouble climbing to a top bunk, please let us know below.

How can we be praying for you?

Payment for Registration*

Adult RegistrationCost covers two nights of accommodations, four meals, and attendance to four sessions, two breakouts, and designated recreational activities. We are unable to differentiate costs for partial attendance.

$100.00 Quantity

Enter coupon

Total

$0.00

Credit Card