Feeding the Flock Registration - Know the Word

Feeding the Flock Registration

"*" indicates required fields

Name*

First Last

Email*

Phone Number*

Texting capable?*

Yes

No

Number of adults*

Over the age of 18

Number of Youth*

Ages 12-17

Number of Children*

Ages 5-11

Name of first adult*

First Last

Name of second adult*

First Last

Name of third adult*

First Last

Name of first child*

Under the age of 18

First

Age of first child*

Under the age of 18

Please enter a number from 0 to 17.

Name of second child*

Under the age of 18

First

Age of second child*

Under the age of 18

Please enter a number from 0 to 17.

Name of third child*

Under the age of 18

First

Age of third child*

Under the age of 18

Please enter a number from 0 to 17.

Name of forth child*

Under the age of 18

First

Age of forth child*

Under the age of 18

Please enter a number from 0 to 17.

Name of first youth*

Under the age of 18

First

Age of first youth*

Under the age of 18

Please enter a number from 0 to 17.

Name of second youth*

Under the age of 18

First

Age of second youth*

Under the age of 18

Please enter a number from 0 to 17.

Name of third youth*

Under the age of 18

First

Age of third youth*

Under the age of 18

Please enter a number from 0 to 17.

Name of forth youth*

Under the age of 18

First

Age of forth youth*

Under the age of 18

Please enter a number from 0 to 17.

Do you or anyone else being registered now have any meal allergies or medical limitations*

Yes

No

Please note all meal allergies and or medical limitations*

For those staying for a partial conference, please contact us at [email protected] for daily rates

Emergency Contact*

First Last

Emergency Contact - Phone Number*

Total

price includes processing fee.

Price: $0.00

Payment Method*

Please mail cheque to: Know the Word PO Box 305 Lanoka Harbor, NJ 08734