Registration Form - 180 Marriage Weekend

Register

Saturday – Sunday

9am – 6pm

English

Childcare available

Registration Form

"*" indicates required fields

Marriage Weekend Date*

180 Marriage Weekend Registration Fee*

Please note all fields are mandatory

HUSBAND

First name*

Last Name*

Date of Birth*

Day*

Year

Cell Phone*

Email Address*

Street Address*

City*

Street Address*

Zip*

WIFE

First name*

Last Name*

Date of Birth*

Day*

Year

Cell Phone*

Email Address*

Street Address*

City*

Street Address*

Zip*

WHO IS FILLING OUT THIS FORM?

Who is filling out this form?*

Husband

Wife

WILL YOUR SPOUSE ATTEND IN PERSON?

Will your spouse attend in person?*

Yes

No

PLEASE SELECT THE PROGRAM

Pricing Field*

In Person Pricing $249/Couple

Virtual $125/Couple

Coupon

Total