Regional Events Group Registration - Camps, Conferences, Retreats

Group Information

Please use this form to register between 1 and 5 team members. To register more than 5, simply submit this form a second time. If you have any questions/issues, please contact us: alyssa@berea.org or 603-744-6344.

For which event are you registering?*

Church Name*

Church City & State*

City State

Individual Registrations

Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Phone*

Please indicate any dietary restrictions:*

Is this attendee over the age of 18?*

Yes
No

Please provide the parent/guardian contact information for this minor:*

First Last

Parent/guardian phone number:*

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Email

Phone

Please indicate any dietary restrictions:

Is this attendee over the age of 18?

Yes
No

Please provide the parent/guardian contact information for this minor:*

First Last

Parent/guardian phone number:*

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Email

Phone

Please indicate any dietary restrictions:

Is this attendee over the age of 18?

Yes
No

Please provide the parent/guardian contact information for this minor:*

First Last

Parent/guardian phone number:*

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Email

Phone

Please indicate any dietary restrictions:

Is this attendee over the age of 18?

Yes
No

Please provide the parent/guardian contact information for this minor:*

First Last

Parent/guardian phone number:*

Name

First Last

Address

Street Address Address Line 2 City State ZIP Code

Email

Phone

Is this attendee over the age of 18?

Yes
No

Please provide the parent/guardian contact information for this minor:*

First Last

Parent/guardian phone number:*

CAPTCHA

Group Registration

Group Information

Individual Registrations

Need help?

CONTACT ALYSSA AT (603) 744-6344 OR ALYSSA@BEREA.ORG