Full Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
City
State / Province
Postal / Zip Code
Will you attend with your spouse?
*
Yes
No
Not Married
Spouses Full Name
First Name
Last Name
Spouses Email
example@example.com
Spouses Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
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Additional Information
This information will help our team prepare lodging, meals, and weekend details with care.
What Events have you participated in:
*
Arise Challenge
Fatherhood Challenge
Father & Daughter Challenge
Father & Son Challenge
Kingdom Outpost Training
Leadership Challenge
Marriage Challenge
Vision Trip
Xtreme Character Challenge
Youth Leadership Initiative
Donor
Has not participated in an event
What Events has your spouse participated in:
*
Arise Challenge
Fatherhood Challenge
Father & Daughter Challenge
Father & Son Challenge
Kingdom Outpost Training
Leadership Challenge
Marriage Challenge
Vision Trip
Xtreme Character Challenge
Youth Leadership Initiative
Donor
Has not participated in an event
What is your t-shirt size?
*
Small
Medium
Large
X-Large
2XL
3XL
What is your spouses t-shirt size?
*
Small
Medium
Large
X-Large
2XL
3XL
Do you have any dietary restrictions or food allergies?
*
Yes
No
What dietary restrictions or food allergies do you have?
*
Does your spouse have any dietary restrictions or food allergies?
*
Yes
No
What dietary restrictions or food allergies does your spouse have?
*
Would you like a handicap accessible hotel room
Yes
No
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Payment Includes:Two-night stay (Saturday & Sunday), Lunch on Saturday and Sunday, and Dinner on Sunday.
*
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( X )
Couple
$625.00
$
625.00
Individual
$425.00
$
425.00
Addtional: Hotel for Friday Night
$199.00
$
199.00
Credit Card
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