Registration

Good News Marriage Conference

First name

Last name

*Partner's First Name

Partner's Last Name

Email

Phone

Preferred method of contact

Name of church you attend:

Would you be interested in childcare?

Yes

No

Number of kids:

Children's Names, ages, any allergies or special directions.

Number of years together:

0-5

4-15

16-25

26+

Pick your top 5 topics of interest.

I am Interested in: Having a Mediator and/or Spiritual Coaching:

Over the weekend as a couple

Over the weekend as an individual

Interested in meeting after the marriage conference

Price per person:

1st Adult : Early Bird Pricing$60

2nd Adult: Early Bird Pricing$60

Child Care (10 & under) Cost is per child$20

It only takes one person to make a difference in their marriage. We encourage you to come even if your spouse is unable to at this time.

U.P.
Revival Is Now