Registration Form
Please fill in the form below.
Full Name
*
First Name
Last Name
First/Last Name of any other adults registering with you (18+)
Names AND ages of all children registering with you (17 and under)
Phone Number (Person Registering)
*
-
Area Code
Phone Number
E-mail (Person Registering)
*
What Church Do You Attend?
Which Suburb / Town do you live in?
How did you hear about this event?
Eternal Purpose Ministries Email List
Eternal Purpose Ministries Facebook Page
Eternal Purpose Ministries Website
From a Friend
From my Church
Facebook Ad
Homeschooling Group / Page on Facebook
Please tick which applies to you (if relevant)
My children are all Homeschooled
My children are in a Christian school
My children are in a Public School
Some children are Homeschooled, some are in public/Christian school
Lunch will be provided at the conference (filled rolls etc.) If you require a Gluten Free option please indicate.
Gluten Free option for 1 person
Gluten Free option for 2 persons
Gluten Free option for 3 persons
Gluten Free option for 4 persons
Gluten Free option for 5 persons
Gluten Free option for 6 persons
Suggestions or topics you would like to see addressed in the conference?
PAYMENT: Please select the option you wish to use. Cost is $15 per adult (18+).
Bank Deposit - we will email details for you to make a payment - you can submit this form without using the payment option below
PayPal - please use option below to make payment via PayPal
PAYMENT
Registration Fee (Required)
$
15.00
NZD
Quantity
1
2
3
4
5
6
7
8
9
10
Total
$
0.00
NZD
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