Customer Details:
Each person attending must complete their own registration form even if you are paying together. Please do not combine payments or information for multiple people in one form.
A Prophetic Pour
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Are you staying at the hotel ?
*
Yes
No
Payment Selections
*
Zelle : 201 697-8439 Annie Royster
Cash App: $jaewillie
Paypal: @AnnieRoyster
Holiday Inn Room
*
King
Double
Will you be attending Sunday Morning Service at the Hotel.
*
Yes
No
Do you have any dietary restrictions ? If yes, please specify
*
T Shirt Sizes & Quantities
*
Rows
T Shirt Size
1
XS - $20
S - $20
M -$20
L -$20
XL - $20
2X - $25
3X - $25
4X - $25
No
2
XS - $20
S - $20
M -$20
L -$20
XL - $20
2X - $25
3X - $25
4X - $25
No
3
XS - $20
S - $20
M -$20
L -$20
XL - $20
2X - $25
3X - $25
4X - $25
No
4
XS - $20
S - $20
M -$20
L -$20
XL - $20
2X - $25
3X - $25
4X - $25
No
Total Number of T Shirts
*
Rows
T Shirt Size
1
Total Cost
*
Rows
Total
1
Conference $165
Total T-Shirt $20-$25
Total amount submitted
Submit
Should be Empty: