Conference Registration Form with Payment

2025 Global Peace & Leadership Summit Registration

September 19-21, 2025 Masjid Ash-Shaheed, 400 Sugar Creek Rd, Charlotte, NC
Full Name

First NameLast Name
E-mail
example@example.com
Phone Number
Format: (000) 000-0000.
City & State

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What age range do you fall into?
Are you interested in attending the free Friday September 19th Escape Room activity after Asr prayer? (Only 16 spots available, preference given to young adult registrants, you are responsible for your own transportation.)
Number of additional people you are registering
Please list their names and email addresses below. If you are not registering others, please scroll down to proceed to payment.
Are the additional guests interested in attending the free Friday September 19th Escape Room activity after Asr prayer? (Only 16 spots available, preference given to young adult registrants, you are responsible for your own transportation.)
Attendee #2

First NameLast Name
E-mail
example@example.com
City & State

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What age range do they fall into?
Attendee #3

First NameLast Name
E-mail
example@example.com
City & State

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What age range do they fall into?
Attendee #4

First NameLast Name
E-mail
example@example.com
City & State

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What age range do they fall into?
Payments are processed through PayPal. You may pay using an existing PayPal account, OR any major credit card / debit card.
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Young adult registration (18-39 years old)
Price increases to $45 after August 20

$45.00 Quantity



Older Adult Registration (40yo and up)
$55.00 Quantity



Awards Dinner Only
$30.00 Quantity



Total

$0.00
Payment Methods

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2025 Global Peace & Leadership Summit Registration

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