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To register electronically, please fill out this form and then click on the "Register" button at the end of the page. You will be taken to our secure e-store where we will gather information necessary to charge your VISA or MasterCard.
Need to clear the form and start over?
Primary Registration |
Full Name #1: |
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Name for Badge#1: |
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I am a... |
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Congregation/
ministry affiliation |
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Presbytery: |
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Clergy Position: |
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Seminarians |
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Congregation of Care |
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Seminary or College |
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Vegetarian meals please |
Other Needs:
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Mailing Address: |
Street:
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City:
State:
Zip:
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Office:
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Home:
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(To save postage, we prefer to confirm your registration via email. Please rest assured, we do not share our email list with anyone. ) |
Emergency Contact: |
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Emergency Phone: |
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| Second Name (if paying with the same credit card) |
Full Name #2: |
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Name for Badge#2: |
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Email for #2: |
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I am a... |
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Congregation/
ministry affiliation |
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Presbytery: |
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Clergy Position: |
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Seminarians |
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Congregation of Care |
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Seminary or College |
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Vegetarian meals please |
Other Needs:
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So far, so wonderful. Now, we need information on your credit card. Please click the registration button below to submit your registration and proceed to the secure e-store where we'll gather information on how to charge your credit card. Your registration will be confirmed via email.
Questions? Call 415 351 2196 or send email to Rosemary Bledsoe
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