Registration Information

Name *

Mobile Phone *

Email *

Will you be bringing guests with you?

Yes

Guest(s) First and Last Name (list all names)

Emergency Contact Name & Phone Number (if one is available)

Home Church (if applicable)

Pastor(s) Name

Conference Details

Will you be attending all conference sessions?

Yes

SPECIAL ACCOMMODATIONS

Do you have any dietary restrictions or allergies?

Yes

RELEASE & CONSENT

I understand that photos and videos may be taken during this event for ministry and promotional purposes. By signing below, I give my permission for my image to be used by Christ Embassy Tennessee. *

Yes

Signature *common.clear

Date *

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Registration Information

Conference Details

SPECIAL ACCOMMODATIONS

RELEASE & CONSENT