REGISTRATION FORM
A separate registration form must be completed for each person in your group that wishes to attend. Full payment is due at registration. If you are registering a group of 10 or more please contact our office at 718-593-8626. Postal & internet registrations must be received by 5:00pm EDT on September 15, 2010. A $25 fee will be charged for incomplete payment transactions.
First Name
Last Name
Title
Church/Organization
Street Address
City State Zip
Email
Daytime Phone Number
Interactive Track Options: You must submit your track choices in order to complete your registration.
Select 3 preferred options.
Note: Leading Urban Church Planting Networks Track is at capacity
1st Choice
1) Campus Movements3) Life Giving Leadership4) Rebuild Haiti Movement5) Prayer Movements6) Mentoring the Millennial Generation
2nd Choice
3rd Choice
1) Campus Movements3) Life Giving Leadership4) Rebuild Haiti Movement5) Prayer Movement6) Mentoring the Millennial Generation
Tracks will be filled on a first-come, first-served basis. You will be informed of the specific track you have been assigned prior to arriving on-site at the conference.
Registration is limited to 800 persons.
CANCELLATION POLICY
If you are unable to attend this conference, you may transfer your registration to another individual. You have until August 31 to cancel your registration and receive a refund, minus a $25 cancellation fee. No refunds will be made after August 31.
The New York City Leadership Center registration@movementday.comPhone: 718.593.8626, x219Fax: 718.721.8220
Please Click Submit Form for Payment options(if you receive an error while submitting the form, please turn off the autofill options on your browser or contact us at 718.593.8626, x219)
