Request edit access
Rooted Women
Understanding our Biblical Role and Identity as Women
For more information or for payment options please contact Samantha Kozinski @ 812-781-9711  


Email *
Participant Name  *
Email *
Birthday (so that we know which groups to place you in) *
Phone number *
How did you hear about the conference *
If you responded "other" please share how you heard about the conference.

Conference Registration Information

Registration Fee

$199 – Shared King Bedroom

$299 – Private Room

This fee includes:

Access to all sessions, guest speakers, and conference materials

Meals: Friday Dinner, Saturday Breakfast, Lunch, & Dinner, and Sunday Breakfast

Schedule

Friday: Check-in begins at 4:00 PM | Welcome Dinner at 6:00 PM

Sunday: Check-out at 12:00 PM
A detailed schedule will be emailed to you prior to the event.

Accommodations
Enjoy a stay in a large 15-bedroom home located in Champions Gate, Orlando, FL.

https://www.vrbo.com/2808711?chkin=2025-09-26&chkout=2025-09-28&d1=2025-09-26&d2=2025-09-28&startDate=2025-09-26&endDate=2025-09-28&x_pwa=1&rfrr=HSR&pwa_ts=1754677340906&referrerUrl=aHR0cHM6Ly93d3cudnJiby5jb20vSG90ZWwtU2VhcmNo&useRewards=false&adults=30&r

How to Register

Click the PayPal link below to submit your registration payment.

Complete the registration form and be sure to click Submit.

*
Scholarships may be available to qualified individuals, please share details about you current financial need. 

If you would like to provide a scholarship for someone, please give us details below.
Tell us about your accommodation needs.  
Clear selection
If you have a roommate already please tell us who so we can assign rooms accordingly. 
Do you have any dietary restrictions or food allergies?
Clear selection
If yes, please let us know what they are
Friday night - Welcome dinner
Clear selection
Are you interested in learning more information about 21st Century Church?
If you have any questions, please type them here so we can respond.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report