Jesus Disciple Territory 1: Marriage Edition

Who’s this registration for?

First name

Last name

Email address

Contact phone

Please list the name of your spouse

Spouse Name

To help us prepare well, please indicate your childcare needs.

If no childcare is needed, please select "No" and type in "0" for the count.

Childcare is $5 per child, per class, payable at childcare check-in.

I am in need of childcare

Yes No

How many children will accompany you? (please list ages)