Clone of 2025 Leadership Registration Form

Retreat Registration Form

Registration Nov. 5, 2025, 3 - 5 pm. Retreat Ends Nov. 7, 2026 with Lunch -- Bonita Park Camp & Conference Center
Name

First NameLast Name
Spouse
Children
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Home Phone

Area CodePhone Number
Cell Phone

5129221257
E-mail
Home Church
Your Leadership Role
(ex: Pastor, Staff, Retired, Chaplain, etc.)
Lodging Preference
Registration Fee Payment Options
You can either go to the following link or use the QRCode shown below to make payment online.

New Mexico District Online Payment with Tithe.ly.
If you wish to print out a copy of this form, click the Print Form button before clicking the Submit button.

To finish the Registration Process, click the Submit button - if you selected Tithley, you will need to use the QRCode shown above. If you leave this page please be sure to return and select the submit button to complete the registration. Also if you select submit mutiple times you will be registered multipule times.
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Retreat Registration Form