412 UNASHAMED CONF. "Free & Fearless" 10th - 13th October, 2019

10th October, 7pm start | Please fill out this form and click submit.

If you require accommodation, we will send you a separate email with an accommodation form to book your stay.

Full Name

*

Birthdate

*

Please format birthdate : 08-01-1995

Email

*

This address will receive a confirmation email

Address

*

Mobile Phone

*

Gender

*

Please select all that apply.

Male Female

Church

*

Please select all that apply.

Christchurch Nelson Kaikohe Warkworth Rarotonga

Would you like accommodation?

*

Please select one option.

Yes No

Catering

Please select all that apply.

Gluten Free

Name of your CG Leader / Connection

*

Payment $55.00

Event Location : Christchurch Celebration Centre

Description

10th October, 7pm start

Please fill out this form and click submit.

If you require accommodation, we will send you a separate email with an accommodation form to book your stay.

Please Fix the Following

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