Contact Information
First Name:
Last Name:
Spouse Name:
Street Address:
Address (cont.)
City:
State/Province:
Zip/Postal Code:
Country:
Home Phone:
Cell Phone:
Email Address:
Date of Arrival:
Accommodation
Area Motel:
RV:
Other:
If registering as an individual, give your age:
 
Emergency Contact
First Name:
Last Name:
Phone Number:

List children who will be attending
Gender
Will go to Bible class
Name
Male

Female

Age
w/parent
Hotel
RV
Extra Information
Ministers: I will be attending the minsters/wives luncheon on Saturday?
I will need airport shuttle from Dayton, OH or Ft. Wayne, IN. Must submit itinerary.
     

Registration questions, please call: (419) 221-0085
Email Convention Registration Questions to: conventionregistration@bcfellowship.org

 

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