Registration - City Pastors

Primary Registrant First Name*

Primary Registrant Last Name*

Ministry Role*

Which breakout session will the primary registrant be attending?*

Email*

Phone*

Name of Church*

Church Street Address*

Street Address 2

City*

State*

Zip*

Do you need to register additional team members for the conference?*

Yes
No

How many additional team members do you need to register?*

Please enter a value between 1 and 9.

Second Team Member

Name of Second Team Member*

First Last

Second Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Third Team Member

Name of Third Team Member*

First Last

Third Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Fourth Team Member

Name of Fourth Team Member*

First Last

Fourth Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Fifth Team Member

Name of Fifth Team Member*

First Last

Fifth Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Sixth Team Member

Name of Sixth Team Member*

First Last

Sixth Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Seventh Team Member

Name of Seventh Team Member*

First Last

Seventh Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Eighth Team Member

Name of Eighth Team Member*

First Last

Eighth Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Ninth Team Member

Name of Ninth Team Member*

First Last

Nineth Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Tenth Team Member

Name of Tenth Team Member*

First Last

Tenth Team Member Ministry Role*

Which breakout session will the primary registrant be attending?*

Register //

Second Team Member

Third Team Member

Fourth Team Member

Fifth Team Member

Sixth Team Member

Seventh Team Member

Eighth Team Member

Ninth Team Member

Tenth Team Member