HOME TEAM “AS FOR ME AND MY HOUSE, WE WILL SERVE THE LORD.” JOSHUA 24:15 ARE YOU REGISTERING AS AN INDIVIDUAL OR COUPLE?(Required) INDIVIDUAL COUPLE FIRST REGISTRANT'S NAME(Required) First Last SECOND REGISTRANT'S NAME(Required) First Last NAME(Required) First Last PHONE(Required)EMAIL(Required) ARE YOU MEMBERS OF LIFEBRIDGE?(Required) YES NO DO YOU REQUIRE CHILDCARE?(Required) YES NO IF SO, PLEASE INCLUDE THE AMOUNT OF CHILDREN AND THEIR AGES BELOW PLEASE NOTE THAT CHILDCARE IS A $5 FLAT-RATE FEE. WHEN PAYING FOR YOUR REGISTRATION, PLEASE ADD THIS CHARGE TO YOUR TOTAL.Upon submitting this form, you will be re-directed to our payment page. Please click the drop-down menu and select "Date Night" and put in the correct payment amount for your registration - $40. You are not registered until payment has been submitted and cleared. For questions, please email info@lifebridge.tv Δ
