EmailMeForm
Marriage Weekend Registration
Please enter your information below to register for the weekend event.
Name
*
First
Last
Spouse's Name
*
First
Last
Address
*
Street Address
City
State / Province / Region
Postal / Zip Code
Phone
*
###
-
###
-
####
Is this your phone or your spouse's phone?
*
Please select
Mine
Spouse
Email
*
Number of Years Married
*
Do you need childcare?
*
yes
no
How many children?
*
Child's age
*
Please select
6 weeks – 12 months
12 months – 24 months
2 years – 4 years
Kindergarten – 5th Grade
2nd Child's age
*
Please select
6 weeks – 12 months
12 months – 24 months
2 years – 4 years
Kindergarten – 5th Grade
3rd Child's age
*
Please select
6 weeks – 12 months
12 months – 24 months
2 years – 4 years
Kindergarten – 5th Grade
4th Child's age
*
Please select
6 weeks – 12 months
12 months – 24 months
2 years – 4 years
Kindergarten – 5th Grade
5th Child's age
*
Please select
6 weeks – 12 months
12 months – 24 months
2 years – 4 years
Kindergarten – 5th Grade
Do you have a middle school or high school student who will attend our youth activities during the weekend?
*
yes
no
How many middle school students will you be bringing?
*
How many high school students will you be bringing?
*
Would you like to pay online? ($40.00 + $1.00 handling fee)
*
yes, marriage retreat online payment
no
Online payments are processed with Paypal and there is a fee of $1.00. If you choose to pay by check, your check must be received in the church office for your registration to be complete.
Total
$0.00
