C2C Midwest Family Gathering Registration
Early bird registration is $75 per person and $100 per couple through the month of August. After August 31, fees are $100 per person and $125 per couple. In-home hospitality is on a first come first serve basis. Blocks of rooms have been reserved at the Holiday Inn Express (660) 956-4682 under the name "Life Church ."

For those wanting to attend remotely, there will be a small $20 registration fee.
First Name *
Last Name *
Preferred email address *
Your phone number including area code
How are you Attending
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Do you have a spouse that will be attending as well?
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Spouse First Name
Spouse Last Name
Your local church name *
Your local church city *
Your local church state *
Your home address *
City *
State *
Zip Code *
Any special needs, allergies or comments you need to share with conference team:
Will you be bringing children with you? *
There is a $15 per child charge that will include all meals that are provided during conference and materials used for childcare. Please note that childcare is provided for children under the age of 12 years.
Please provide the name and age of each child.
Please list any special needs you may have for you child here.
When will you be arriving in Kirksville?
When will you be departing Kirksville?
Are you requesting in-home-hospitality? (This is limited)
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