Registration

Fill out the following form to register for the upcoming Great Banquet!

Please note: Women’s registration is closed and waiting list is full.

Great Banquet Event *Men - March 19-22, 2020

First Name *

Last Name *0 / 180

Email Address *

Phone Number

Mobile Phone *

Street address *

City *

State/Province *

ZIP / Postal Code *

Age *0 / 5

Marital Status SingleMarriedWidowedSeparatedDivorced

Church Affiliation, if any0 / 180

Why to you want to participate in the Great Banquet, what are your expectations? *0 / 180

Message0 / 180

Emergency Contact 1

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Emergency Contact 1 Name *

Emergency Contact 1 Email Address *

Emergency Contact 1 Phone *

Emergency Contact 1 Relationship *0 / 180

Emergency Contact 2

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Emergency Contact 2 Name *

Emergency Contact 2 Email Address *

Emergency Contact 2 Phone *

Emergency Contact 2 Relationship *0 / 180

Special Needs

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Do you have a health issue or physical handicap that may affect your attention at the Great Banquet? NoYes

Are you on a special medication? NoYes

Do you have food allergies or a special diet? 0 / 255

Who Invited You to the Great Banquet

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Name *0 / 180

Phone *0 / 180

Email Address *

Date

Register Now

If you have any issues with registration, contact US at info@northshoregb.org