Strange Days: Christian Faith in Shifting Times - March 17-18, 2018

Please fill out this form to register for the conference at Grace Community Church on March 17-18, 2018. Call 251-345-3303 if you have any questions.

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Number of Adult Attenders

*

Please select one option.

1 2 3 4

Names of Other Adult Attenders

Number of Children Who Require Childcare

Please select one option.

1 2 3 4 5

Conference Registration Fee

1 Adult ($20.00) 2 Adults ($40.00) 3 Adults ($60.00) 4 Adults ($80.00)

Amount

Childcare Fee

0 Children (0) 1 Child ($5.00) 2+ Children ($10.00)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form to register for the conference at Grace Community Church on March 17-18, 2018. Call 251-345-3303 if you have any questions.

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