Registration Form
Email address *
First Name *
Last Name *
Phone Number *
Email *
Name of Congregation *
Location of Congregation *
Name of Youth Pastor or Congregational Leader
How many people are coming with you? *
Which topic-based discussion group would you like to participate in: *
Please submit the following:
A photo of you (so we can highlight your Congregation’s participation with graphics)
If possible, a logo of your Congregation
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