TEN Midwest - Regional Gathering

TEN Midwest - Regional Gathering - Registration Form

"Pioneer, Build, Establish"

Worship Retreat - Connect and be Refreshed - July 10 - 11, 2026
Full Name

First NameMiddle InitialLast Name
Date of Birth

MonthDayYear
Date Now (Hidden)

MonthDayYear
Date
Age
E-mail
Please fill in a valid email address
Phone Number
Phone numberFormat: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
If registering as a team please list Team Members' names here.
Team members must all agree to the media release and liability waiver.

Parent/Guardian Consent required
Is this registration form for a youth 17 years and under? If yes, please add your name and signature below.
Parent/Guardian - Please add your full name

First NameLast Name
Parent/Guardian Signature
Payments via PayPal to:
tenteamdirector@tenworldwide.org

After registration please make your payment via PayPal.
See thank you page for the link.

Please note that any administration costs will be your responsibility and should not be deducted from the conference fee. This ensures your registration is processed smoothly and without delays.

Confirmation will be sent out once payment is received.
My Products - Payment via PayPal (see info above)
prevnext( X )
48-hour Registration Flash Special ENDS 9 AM on 6/7/2026
Early bird registration until Monday, June 22nd; thereafter $65.00 (adults)!

$40.00 Quantity



Conference Registration (early bird special) until June 23
Early bird registration until Monday, June 22nd; thereafter $65.00 (adults)!

$50.00 Quantity



Conference Registration - Youth Rate
Registration for Youths age 14 years and under

$15.00 Quantity



Total

$0.00
General Information:

Please note that registration for the Regional Gathering includes: conference, and workshop on the days of the gathering (July 10 - 11, 2026).

For your Personal Expenses: Flight, Hotel, Transportation, Food (lunch), Snacks, etc., Offerings.

Media Release & Consent Statement/ Liability Waiver
By registering for the Regional Gathering, I hereby grant permission to the organizers:

Capture Media: Take photographs, video recordings, and audio recordings of me during the event (July 10 - 11, 2026).

Usage Rights: Use, publish, and distribute these images or recordings in print and digital formats, including social media, websites, and promotional materials.

Ownership: I understand that all such media remains the property of the event organizers and that I will not receive financial compensation for their use.
I acknowledge and agree to the following:

Assumption of Risk: I understand that participation in the Regional Gathering and workshops may involve physical activity. I voluntarily assume all risks related to exposure to illness or personal injury.

Release of Liability: I hereby release the organizers and The Eagles Network TEN Worldwide from any and all liability, claims, or demands for personal injury, sickness, or death that may occur during my participation.

Personal Limitations: I certify that I am participating based on my own physical limitations and health status. I am responsible for monitoring my own well-being and will cease participation if I feel overexerted or unwell.

Medical Responsibility: I understand that I am responsible for any medical expenses incurred as a result of my participation.
Liability & Participation Waiver
Signature
Payment Methods

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

My Products - Payment via PayPal (see info above)

General Information:

Media Release & Consent Statement/ Liability Waiver

Payment Methods