2017 Dance The Word Conference Registration

Registering Online
  • You must use a credit card. We only accept Mastercard and Visa.
  • There is a $5 service charge with the use of a credit card.
  • Do not use this website to register a group at the Group Rate.
  • Complete a form for each participant in your group. Please mail completed forms with group total payment.


  • Don't Want to Register Online
  • If you prefer not to pay by credit card, complete this form, print it out and mail in with your payment.

  • Add Registrant

    *REQUIRED FIELDS

    Registrant Information
    *Age Range:   *Dance Director:   *First Time:  
    *Title:   *First Name:   *Last Name:  
    *Address:  
    *City:   *State:   *Zip:  
    *Home Number:   Other Number:   *Email Address:  


    Church Affiliation
    Church Affiliation:
    If you have a church home that is not provided in the list above, then please provide your Church information below
    Church Name:
    Address:
    City: State:


    Rate
    Conference Registration Includes:
    Workshops, Gift, Lunch & Evening snacks and Evening Worship Experiences
    Day Rates:
    Workshops, Gift, Lunch & Evening snacks and Evening Worship Experiences
     
    *Category Type:   *Rate:  


    Promotional Items
    Conference T-shirts will be the attire on July 15 at the closing Dance The Word Worship Service
    ProductDescriptionSelection
    Make your selections
    Conference Video (DVD) Thursday Qty Thursday   ($10.00)
    Conference Video (DVD) Friday Qty Friday   ($10.00)
    Conference Video (DVD) Saturday Qty Saturday   ($10.00)
    Conference Video (DVD) Set (Thursday, Friday & Saturday) Qty Set (Thursday, Friday & Saturday)   ($25.00)
    T-Shirt Adult Conference Qty Small   ($16.00)
    Qty Medium   ($16.00)
    Qty Large   ($16.00)
    Qty X-Large   ($16.00)
    Qty 2X-Large   ($18.00)
    Qty 3X-Large   ($18.00)
    Qty 4X-Large   ($20.00)
    Qty 5X-Large   ($20.00)
    T-Shirt Children Conference Qty Small   ($12.00)
    Qty Medium   ($12.00)
    Qty Large   ($12.00)


    Payment Information
    Billing Address: Check box if same as registrant address above
    *Billing Address:  
    *Billing City:   *Billing State:   *Billing Zip:  
    *Billing Phone:
    $5 service charge with the use of a credit card
    *Card Type: *Card Number:
    *Expiration Date: / *CSC:
    *CardHolder First Name: *CardHolder Last Name: