Participant Registration

Sarasota Church The Living Sanctuary Your Choice of Sarasota Churches Non-Denominational Christian Church Bible based Fellowship

THE LIVING SANCTUARY Men's Encounter July 30th - Aug 1st! Click on "The Encounter!" link for details...
Real Word ~ Real Worship ~ Real People To reach, teach and build people for the purposes to which God has called them!

Participant Registration Form

* Required Field

*Participant Name:	Female Male
* (Please ensure you have selected the correct date)

So We Can Contact You ...

*Street Address: *City: *St: *Zip:

Email Address:

*Home Tel# (include area code): Cell# (include area code):

Tell Us About Yourself ...

*Currently: *Your Age: How Many Children:

Spouse's Name:

What Church Do You Attend:

Who Referred You:

Please tell us of any special needs, including lodging, medical and meals:

Emergency Contact Information (just in case!)

*Emergency Contact Person:

*Relationship: *Phone# (include area code):

How Will You Pay?

*Please select your payment option:

Already Paid Mail a Check Pay Online

A $50 deposit is due when you register. The full balance of $135 is due two weeks before the retreat date. If you are paying by check, please make your check payable to "The Living Sanctuary Church". All payments are non-refundable and non-transferable, as reservations are made immediately upon receipt of registration form. If you have a question, you can contact us by phone at 941-365-LIFE or by email by clicking <here>.

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Note: if you are completing this form for someone else, please make sure that they are aware and approve!

*Please Enter Your Name (person filling out the form):

*Today's Date (mm/dd/yy):

If the applicant is 18 or younger, you must have your parent's or guardian's approval to attend an Encounter weekend ... please enter your initials to confirm you have done so:

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