WICHITA QUAKE

Group Information

Registrar Name*

Registrar Email*

Registrar Cell Phone Number*

Group Leader's Name*

Group Leader Cell Phone Number*

Group Leader Email*

Church Name*

Church Address*

Church Phone Number

What Denomination is Your Church?*

How Did You Hear About Quake?*

Registration Items

Middle Schoolers (Late)

$159.00/ea.

High Schoolers (Late)

$159.00/ea.

Adult Leaders (Late)

$159.00/ea.

Email [email protected] for hotel room inquiries or to add more registrants. Rooms are not guaranteed after the Standard deadline.

PLEASE NOTE: There are no adjoining rooms at this hotel.

Order Total

$0.00

Add a Donation

Donation Amount

Suggested Amounts

$100
$250
$500
$1,000
Other

What fund would you like your donation to go towards?

Quake Ministry
General Life Promotions Fund

Coupon Code

RegFox Event Registration Software

Event Registration Software by RegFox