Regional Assembly Registration

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Please complete a separate registration for

EACH adult/youth/child attending.

Agefor youth/children only
Gradefor youth/children only
Childcare needed?
When
Title
First Name
Last Name
Preferred Badge Name
Mailing Address
City
Zip
Phone
Statuspick one!
Church
City of Church

REGISTRATION FEE FOR ADULTS ONLY (NO FEE FOR CHILDREN OR YOUTH

Registration Fee

MEALS FEES FOR ALL AGES

Meals
Food Restrictionsplease enter any food allergies

Please mail registration and food fees to:


Christian Church in Montana

1019 Central Avenue

Great Falls, MT 59401

Nameyour full name
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