2025 Leadership Summit Registration
Please fill in the form below to register. You will receive a Registration Confirmation from the Registrar.
Contact Information
Full Name
*
First Name
Last Name
E-mail
*
Address
Street Address
Street Address Line 2
City
Please Select
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Zip Code
Phone Number
*
-
Area Code
Phone Number
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*
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Church Information
Church Name
*
Pastor's Name
*
Church Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Church Email
*
example@example.com
Name(s) of Registered person(s)
Registration is $50 per person. Please select the quantity of persons registered with this submittal.
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2026 Leadership Summit Registration
$
50.00
Includes meals
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Total
$
0.00
Delegate 1
*
Title
First Name
Last Name
Ministry Role
Delegate 2
Title
First Name
Last Name
Ministry Role
Delegate 3
Title
First Name
Last Name
Ministry Role
Delegate 4
Title
First Name
Last Name
Ministry Role
Delegate 5
Title
First Name
Last Name
Ministry Role
Delegate 6
Title
First Name
Last Name
Ministry Role
Delegate 7
Title
First Name
Last Name
Ministry Role
Delegate 8
Title
First Name
Last Name
Ministry Role
Delegate 9
Title
First Name
Last Name
Ministry Role
Delegate 10
Title
First Name
Last Name
Ministry Role
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