Youth Encounter - Participant Registration

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Complete Transformation Ministries Inc.

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Youth Encounter Participant Registration

* Indicates required field

First name *

Last Name *

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Nickname (name you would like to be called for the weekend) *

Gender *

Male Female

Age *

Relationship Status *

Single Married It's Complicated

I Was Referred by (First Name, Last Name) *

Are you part of a Christian small group (3-20 people) that meets consistently? *

Yes No

Is this your first time attending our Encounter? *

Yes No

Is English your primary language? *

Yes No

Emergency Contact Person (First Name, Last Name) *

Emergency Contact Phone Number *

Emergency Contact Email Address *

Please list any special needs *

What do you want to get out of this Encounter Weekend? *

Submit

Home
Our Schedule
- Encounters >
- Upcoming Events >
  - RSVP Christmas Celebration
  - Abide Nights
About Us
- Freedom In Action
Our Team
Give