Registration

Jan 2025

Attendee Information:

First Name

Last Name

Phone

Address

Address 2

City

State

Zip

Contact Person:

We would like to speak to your spouse, a member of your family, or a friend 2 weeks prior to the encounter to ask them to pray for and encourage you. Please provide one contact

First Name

Last Name

Phone

Attendee Questions:

Launch Point

The Launch Point is the area location we will meet up before attending Encounter.

Who invited you?

Please provide full name of person.

What church do you attend (if any)?

Concerns?

Let us know if you have any dietary concerns, physical limitations or health concerns

Questions or Comments?

Payment Method

Registration

Jan 2025

Ben Kormanik

Jared McJunkin

Shane Tiffany