GBC Family Conference

Please fill out this form to register for the Family Conference at GBC on September 25&26.

For more information go to gashlandbc.org/famconf or email PastorBrett@gashlandbc.org.

Name

*

Email

*

This address will receive a confirmation email

Phone

*

Address

*

How Many Family Members Will Be Attending? (Including Parents & Children)

*

Please select one option.

1 2 3 4 5 6 7 8 9 10+

How Many Of Your Children Will Need Nursery Services?

*

Please select one option.

1 2 3+

Payment ($15 per Adult Member of GBC, $30 for Non-Members)

1 GBC Adult ($15.00) 2 GBC Adult ($30.00) 1 Non-GBC Adult ($30.00) 2 Non-GBC Adult ($60.00)

Amount

Optional Family Fun Farm Tickets ($5 per person)

Not Going (0) 1 Person ($5) 2 Persons ($10) 3 Persons ($15) 4 Persons ($20) 5 Persons ($25) 6 Persons ($30) 7 Persons ($35) 8 Persons ($40) 9 Persons ($45) 10 Persons ($50)

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

Please fill out this form to register for the Family Conference at GBC on September 25&26.

For more information go to gashlandbc.org/famconf or email PastorBrett@gashlandbc.org.

Please Fix the Following

Close