Journey Conference Online Registration

This form will allow you to register for The Journey to Wholeness in Christ Conference at Christ Church in Mobile, Alabama on October 20-22. Please fill the form out completely and click submit. [Note: we regret that child care is not available.]

Today's Date: *

Name: *

Address: *

City, ST: *

Zip Code: *

Phone: *

Email: *

If you have attended a Journey, please indicate when and where:

If you are receiving counseling or are seeing a professional therapist, please indicate the reason(s):

Occupation:

Church Affiliation:

Registration Type: *

Individual ($80)

Married Couple ($150)

Ordained Pastor ($65)

Ordained Pastor & Spouse ($130)

Payment Type: *

I will pay online. The system will take me to the secure payment system after I click Submit.

I will pay by check and will mail or deliver the check to Christ Church.

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This question is for testing whether you are a human visitor and to prevent automated spam submissions.

What is the fifth word in the phrase "evi eqer uta ciluvu jew"?: *

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