Raise the Colors Men's Conference Registration Form

Raise the Colors Men's Conference Registration Form

Please fill out your details to register for the conference. Registration is NOT complete until $75 payment is made. If you are staying overnight, hotel cost is due with registration. If not pre-registered, cost is $100 on the day of.
Full Name

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Are you staying overnight at Rhodes Grove?
0, 1, or 2 nights? Cost is $90 per night. (If you share a Hotel Room, you are responsible for splitting costs). Only 1 person per hotel room enter this section and the next.
Total Cost for Hotel Room: $00/$90/$180: (Only 1 person per hotel room enter this section)
Are you staying for breakfast Sunday morning? (Cost is an additional $10)
Donation Amount: ($75 for conference includes Saturday breakfast and lunch) + ($90 per night for hotel room if staying overnight)

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Payment Methods

Choose from one of the PayPal options to make your payment.
Should be Empty: