D2BregistrationCK

Registration Form
Pay By Check

* Indicates required field

Name *

Email - if you do not have an email, you may leave this blank. However, we do most of our communicating via email, and you may miss important information if you do not submit an email address. *

Phone Number *

Address: *

Address Line 2 *

City *

State *

Zip Code *

TICKET SELECTION:

Choose One *

Ticket WITH PreEvent Labs - $60 Ticket WITHOUT PreEvent Labs - $45

If you are using a COUPON CODE today, please enter it here. You will enter it again on the CHECKOUT page. *

Your Age Bracket *

Do you attend church? If so, where? *

How did you hear about this event? *

Been to a previous event? *

YES NO

Would you like to be added to our mailing list? (We keep this info private.) *

YES Not at this time

TERMS:
Buyer understands ticket is a non-refundable ticket. In the event the registered attendee cannot attend, ticket can be transferred to another attendee. Ticket will be mailed to attendee and is to be brought to event.

Buyer understands there will be photos and video taken at the event, and consents to being photographed and/or filmed at the event.

I agree to the terms above *

YES

Comments or Questions? *

Fill out the form to the left.
All fields with a * are required.
The address you submit on this form will be the address to which we mail your ticket.
After you click NEXT, you will be taken to another page with payment instructions and an address.
We will send you a confirmation email once we have processed BOTH your registration AND your payment. If you do not hear from us within 3 business days, please contact Donna at [email protected].
Tickets are being mailed out as registrations and payments come in. PLEASE BRING YOUR TICKET to the conference. If you do NOT receive your ticket in time for the conference, simply proceed to the check-in table.

Registration Form Pay By Check

REGISTRATION* Please read this section BEFORE completing your registration.

Registration Form
Pay By Check

REGISTRATION
* Please read this section BEFORE completing your registration.