Register here or download the PDF Registration form for your church's or group's bulk registration.

The cost for the entire conference is $20 (Saturday continental breakfast and lunch included).

Register here now, or at the door Friday or Saturday.

(** Required Fields)  

 First & Last Name **
   
 Address **
   
 City, State, Zip  **
    
 Email **
   
 Phone **
   
 Church/Ministry Name **
   
 Marital Status **
  		 Age **
   
Are you a leader of a college ministry?    
Are you registering as the representative for a group or for your spouse? If so, list the name and email address of each person being registered for Take My Life.
   
How did you learn about this conference?
  
 

 

 

 

 

 

 

 

  
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