The Intentional Marriage Registration Form

The Intentional Marriage

Please fill in the form below to reserve your seats! Space is limited to 12 couples. After that, we will create a waiting list in case of cancellations.
Husband Name*

First NameLast Name
Wife Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number*
E-mail*
example@example.com
Do you have any dietary allergies? We cannot accommodate all dietary needs. However, when possible, we will try to do what we can. We will contact you with options, if available.

My Products*

Registration Fee / couple (Required)Registration includes dinner for husband and wife along with a night of fellowship and encouragement.

$50.00

Total

$0.00

CANCELLATION POLICY: If cancellation is made prior to 7 days before the event, a full refund will be given. After 7 days before the event, only partial refunds (minus cost of the dinner) will be given. If we have a waiting list and are able to refill your seat, a full refund will be given.*

I understand and agree to the cancellation policy.
Should be Empty: