+916 452-2626
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Individual Registration

ATTENTION!

Please do not start the registration process if you are not ready to pay at the end by a credit card or PayPal.
Please fill out the form in English only!
Please also do not use Back button during all the registration process. If you need to return to a previous page, please use buttons at the bottom of the page.

Registration fee: $42.00 ($2.00 -- PayPal charges).
Registration ends: October, 26.

Should you have any questions about the registration, please call (916) 452-2626 or email at This email address is being protected from spambots. You need JavaScript enabled to view it..

TERMS AND CONDITIONS

Should you cancel the registration later, please do it before October 25. After October 25, your registration fee is not refundable.

First Name *

Last Name *

Phone *

Email *

Name of church you attend *

Enter name of the church you attend. Otherwise, enter N/A in this field.

Senior Pastor's First and Last Names *

What is your registration status? *

Delegate

Guest

Comment

Enter your comments or any additional information you think we need to know. Otherwise, put N/A in this field.

I agree with terms and conditions *

Yes

The registration cannot be completed without you're agreeing to the Terms and Conditions

Payment Information

Credit Card Holder's First Name *

Please enter the credit card holder's first name

Credit Card Holder's Last Name *

Please enter the credit card holder's last name

Amount

Payment Method

Paypal

Credit Card Number*

Expiration Date*

Card (CVV) Code*

Card Holder Name*

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Feel free to contact us if you have any questions