Registration Form

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Wichita KS /

November 2-4, 2018

Registration Form Name:

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Address:

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Telephone: Email: (for email confirmation)

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Church Name:

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Student Registration: $10 early bird/ $15 after Oct. 1st (Students are ages 13-22 and enrolled in school.) Regular Registration:

$55 early bird/ $65 after Oct. 1st

T-shirts can be pre-ordered with an additional payment mailed with this registration form. A limited supply of t-shirts will also be available at the conference. Please mail this form and make check payable to: Victory Fellowship Foursquare Church/ 693 Road 190/ Emporia, KS, 66801.

T-shirt order T-shirts are available in adult small thru XL for $10 and up to 4XL for $12 per shirt. They are all available in maroon, turquoise, and charcoal. Size

Quantity

Color

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