"Conversations that Connect" Conference Registration
Please reserve your spot for the conference by filling the form below, specify the expected number joining the conference. (Lunch will be sold on site.)
Full Name
*
First Name
Last Name
E-mail
*
Phone Number
*
-
Area Code
Phone Number
Church
*
I am a...
*
Student
Regular attender (non-student, attending individually)
Church Leader (registering a group)
Other
Number of people attending
*
If attending as a group, please indicate how many you are registering for the conference.
Registration Fee
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Individual Registration
$
10.00
Quantity
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Total
$
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Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Register
Should be Empty: