Impacting The Nations 2024 - Registration Form

3/04/2023 - 7/04/2023 | IMPACTING THE NATIONS CONFERENCE
3rd - 7th APRIL 2024

Registration Pricing: $40.00pp (13years+)

Registration for High-school age NOT attending Easter Conference can be added to this form.
For Childcare Registration please see separate form
For Springbank Accommodation Registration please see separate form

Person 1 (Main Contact)

Name

Gender

Please select one option.

Female Male

This address will receive a confirmation email

Phone

Church

Please select one option.

Africa Christchurch Dubai Kaikohe Korea L.A Melbourne Myanmar Nelson Nepal Pakistan Philippines Rarotonga San Francisco Thailand Warkworth Not currently attending a Church Other church

Person 2

Name (Person 2 )

Gender (Person 2 )

Please select all that apply.

Male Female

Person 3

Name (Person 3)

Gender (person 3)

Please select all that apply.

Female Male

Person 4

Name (Person 4)

Gender (Person 4)

Please select all that apply.

Female Male

Childcare - Please See Seperate Form

Springbank Accommodation - Please See Separate Form

Terms & Conditions

From time to time, videos and photos from events may be published for promotional purposes. Your registration for this event confirms agreement with these terms and conditions.

Registration Price: $40 Per Person

1 Person ($40) 2 People ($80) 3 People ($120) 4 People ($160)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

3/04/2023 - 7/04/2023

IMPACTING THE NATIONS CONFERENCE
3rd - 7th APRIL 2024

Registration Pricing: $40.00pp (13years+)

Registration for High-school age NOT attending Easter Conference can be added to this form.
For Childcare Registration please see separate form
For Springbank Accommodation Registration please see separate form

Impacting The Nations 2024 - Registration Form

Description

Please Fix the Following