Church Renewal Weekend Registration Form

Registration for Church Renewal Weekend Oct 26 - 29, 2018

If you are a part of a group, register on your group's page. Or make a group.

Or you may sign up for a different retreat.

First name:

Last name:

Email:

Phone:

Mailing address:

City:

Country:

Province/State:

Postal Code:

Age:

Gender: Male Female

Marital status:

Do you need translation? No Yes

Name of home church:

Size of church: (weekly attendance)

Denomination:

Are you currently in Church Renewal mentoring? Yes No

Position in Church/Org./Denomination:

Have you attended a Set Free! retreat? Yes No

Have you attended a Hearing God Seminar? Yes No

How did you hear about Church Renewal?

Who referred you?

Name:

Email:

Phone:

Is spouse attending too? Yes No

Special needs: (allergies, mobility, etc)

Severe food allergies?
Call Pam Kehler @ 204-326-9020
or email pamk@mysouthland.com

For all other enquiries, email info@churchrenewal.com