Register:
All Bold fields are required.
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Starred (*) items will be published in the conference directory
as part of all conference attendee's packets unless
committee is notified not to publish!
Please be sure to SCROLL DOWN and fill in all required areas!
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Login Name
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Password
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Repeat Password
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Title
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Ms.
Mrs.
Miss
Rev
Other:
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First Name*
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Middle Initial*
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Last Name*
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Email*
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Mailing Address*
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Apt # *
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City*
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State*
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Zip/Postal Code*
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Country*
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Home/Primary Phone # *
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Mobile Phone #
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Fax #
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Gender
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Favorite Quote
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Latest News
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Congregation*
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Province*
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District*
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Emergency Contacts
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First Emergency Contact Name
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First Contact Relationship
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First Contact Primary Phone #
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Primary Phone Type
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Home
Work
Cell/Mobile
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First Contact Alt Phone #
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Alt Phone Type
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Home
Work
Cell/Mobile
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Second Emergency Contact Name
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Second Contact Relationship
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Second Contact Primary Phone #
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Second Contact Primary Phone type
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Home
Work
Cell/Mobile
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Second Contact Alt Phone #
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Second Contact Alt Phone type
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Home
Work
Cell/Mobile
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Transportation
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ARRIVAL/CHECKIN DAY IS THURSDAY, JUNE 23 2011 between NOON and 6:00 PM
Earlier arrivals and those who wish to extend their stay must make separate
accommodations with Embassy Suites or another area hotel!
FLIGHT INFORMATION:
Charlotte/Douglas International Airport (CLT) Charlotte, NC
is the ONLY airport that transportation to/from the conference will be provided!
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Mode of Transportation
to Conference
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Personal vehicle
Airline
Charter bus
Non-charter bus
Church bus
Other
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Flight Arrival Day
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Flight Arrival Date (mm/dd/yyyy)
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Arrival Flight Number
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Flight Arrival Time (xx:xx AM or PM)
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Flight Arrival Airline
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Flight Departure Day
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Flight Departure Date (mm/dd/yyyy)
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Departure Flight Number
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Flight Departure Time (xx:xx AM or PM)
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Flight Departure Airline
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Lodging
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CLICK HERE FOR SINGLE DAY REGISTRATION!
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Conference Fee Selection
Each suite has two double beds
and a full size sleeper sofa
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The QUAD option requires that two people will need to share one bed.
You must select ALL your roommates and list them below!
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Roommate #1
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Roommate #2
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Roommate #3
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Assign me a Roommate
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Check your age group for assignment
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20's |
30's |
40's |
50's |
60's |
70's |
80's +
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Special Needs
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Wheelchair
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Handicapped Accessible Room
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Special Diet (be specific)
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Special Diet Needed-
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Workshops
Workshops will be repeated.
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Click Here to View Workshop Descriptions
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Please select different
workshops for each morning:
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First Morning Workshop
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Second Morning Workshop
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Please select different
workshops for each afternoon:
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First Afternoon Workshop
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Second Afternoon Workshop
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Volunteer Jobs
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Diener Volunteer
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Dieners serve at the Lovefeast Service. We anticipate more volunteers than we can use,
so selections will be made randomly and notification will be made by email.
If you do not have an email address, please indicate your church’s email address on your form.
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Greeter Volunteer
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Greeters will welcome attendees as they arrive at the conference, serve as ushers at our
joint services, and assist with trays for those who may need assistance at meal time.
We anticipate more volunteers than we can use, so selections will be made randomly
and notification will be made by email. If you do not have an email address, please
indicate your church’s email address on your form.
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T-Shirt Orders
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Each T-Shirt is $10 US - total will be added to your conference fee
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QUANTITY
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Small
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Medium
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Large
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X-Large
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XX-Large
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TOTAL # SHIRTS
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Total T-Shirt Cost $
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TOTAL DUE
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$
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This form completes registration;
You will pay later by PayPal or check
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You will receive an email confirming registration and listing your login information.
After logging onto your new account, you will be able to pay via PayPal.
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