Eastern & Southern States Council 2025 Winter Conference

Fields marked with * are required

Email Address*

example@example.com

Billing Name*

PrefixFirst NameLast NameSuffix

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*

MonthDayYear

Please Note: We use Paypal as our payment processor. A Paypal account is not required. All major credit cards are accepted. Select Credit Card or Payal option below.

Total

USDTotal Conference Registrations

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Eastern & Southern States Council 2025 Spring Conference