New York 2017 - Individual
Room Type
Select Your Registration
Single Participant - Private Suite (Add $1,975.00)
Single Participant – Shared Suite (Add $1,495.00)
First Name
*
Last Name
*
Roommate Information
Your Gender
Male
Female
If you have a roommate preference, please list their name here:
Contact Information
Telephone
Address
*
City, State, ZIP
*
Your Email Address
*
Church Name
Church Location (City / State)
Additional Payment (ignore unless otherwise instructed)
$
Comments (Special Needs, etc.)
Charges will appear from ST. MARTIN BAPTIST FELLOWSHIP
Total
$
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