Conference Registration Form
Register to attend the Uprooting the Curse Conference and prepare your details.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Church Affiliation
Do you have any special requirements or notes?
Register
Registration Options
*
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( X )
Early Registration
April 1-June 30th
$95.00
$
95.00
VIP Registration
Includes Registration and other event products
$199.00
$
199.00
Regular Registration
July 1-September 1
$125.00
$
125.00
Product Name
Free
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Payment Methods
Credit Card
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
Afterpay
After submitting the form, you will be redirected to Afterpay to complete the payment.
Should be Empty: