First Name:

Last Name:

E-Mail:

Address:

City:

Zip:

Home Phone:

Cell Phone:

Church Attending:

Denomination:

Life Experience:
Under 25
25-25
35-50
50-60+

Bible Study Experience:
None
Little
Medium
Advanced

Nusery Needed?
Yes
No

Ages of Children (for Nursery):

Ministry Gifts - Check all talents you are willing to share:
Intercessors
Music
Video(PowerPoint)
Media(recording)
Service Project
Year End Brunch
Sonshine(flowers & cards)

Are there any other gifts/talents not listed above that you would like to share?

Registration Fee is $35. If you would like, you can add a donation amount to help someone else attend. Choose ONE of the options below:

Pricing Options
Single Registration Fee $35
Registration plus 10 dollar donation $45
Registration plus 20 dollar donation $55
Registration plus 35 dollar donation $70

(Only click the Submit Button Once)