Registration Form for the 2019 Southeast Nurturing Communities Network gathering at Koinonia Farm Friday to Sunday, October 11-13, 2019

Registration limited to the first 36 People. Don't Delay.

Come join us! Fill out the form below to register for the 2019 Southeast Nurturing Communities Network (NCN) Fall gathering. The gathering will be hosted by Koinonia Farm starting with a welcome dinner Friday , and ending with breakfast and devotions on Sunday. Suggested donation of $70-$100 per person includes both room and board. For any questions or need for special arrangements, please email Tim Hochstetler at

There is an optional pre-conference visit to El Refugio ( on Friday morning. If you are interested in participating, please plan to arrive at Koinonia by 8:30 a.m. that morning. We will caravan from there.

We look forward to times of worship, fellowship, and inspired conversation.

Read about historic Koinonia Farm at

• Koinonia Farm • 1324 GA Hwy 49 S • Americus, GA 31719 • 229 934-0391 •
Email address *
Personal Details
Name *
Your answer
Phone number
Your answer
Community Details
Community Name (if you live in an intentional community)
Your answer
Street Address
Your answer
City, State, ZIP Code
Your answer
Conference Details
I am registering with another individual and would like to share a room. NOTE: Most rooms at Koinonia are double occupancy, but there are several rooms with four beds for groups or families. Please indicate below if you are willing to share one of these larger rooms if available. Name of individual (s)
Your answer
I plan to bring _______child/children to the Gathering and will need childcare.
Your answer
Names of children (and ages).
Your answer
Dietary Restrictions
Any other information that we should know?
Your answer
I plan to participate in the pre-conference trip to visit El Refugio and will arrive at Koinonia by 8:30 a.m. that morning. *
Next Steps
Put the date of the gathering (Oct.11-13, 2019) on your calendar. We'll confirm details closer to the gather date.
A copy of your responses will be emailed to the address you provided.
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