Nazarene Regional Conference 2020
Registration will be considered complete when the following is complete:

a. this form is filled out and submitted electronically

b. the registration fee has been received at the Regional Office - please contact your district office to turn it in before the deadline.
Email address *
Registration for the Haiti Field
October 7-11, 2020 Panama City, Panama
Early Registration Deadline: December 31, 2019
FEE: US $100 (Fee received by Deadline date)

Regular Registration Deadline: January 1, 2020 – June 30, 2020
FEE: US $150 (Fee received by Deadline date)

Late Registration Deadline: July 1, 2020 – October 1, 2020
FEE: US $200 (Fee received by Deadline date)

At the Door Registration: (Fee received at the Conference or after)
FEE: US $300
First and Last Name *
Date of Birth *
Gender *
WhatsApp # or Mobile *
Please include country area code - for example: 509 for Haiti.
District *
Local church that you are coming from: *
EXAMPLE: Barreau Matin Eglise du Nazareen
Name of your Pastor: *
EXAMPLE: Rev. _____ _________
What ministries are you involved in at church: *
Check all that apply:
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