Event Registration Form Event Registration Event Information Event Date * Please select an event date Event Time * Please select an event time Event Duration * Select duration 1 hour 1.5 hours 2 hours 2.5 hours 3 hours 4 hours All day Multi-day Please select event duration Personal Information First Name * Please enter a valid first name Last Name * Please enter a valid last name Email Address * Please enter a valid email address Phone Number * Please enter a valid phone number Address Information Address * Please enter your street address City * Please enter your city State * Select State Please select your state ZIP Code * Please enter a valid ZIP code Country * Select Country Please select your country Church & Service Information Church Name Are you currently serving with Refuge? * Yes No Please select an option Where are you currently serving? * Local Church Community Outreach International Mission Youth Ministry Worship Team Administrative Other Please select at least one option Additional Information Would you like us to keep you informed on upcoming events? * Yes No Please select an option How did you hear about this Refuge event? * Social Media Friend/Family Church Announcement Website Email Newsletter Radio/TV Print Media Other Please select at least one option Do you give Refuge International permission to use your photo in promotional materials? * Yes No Please select an option Register Now Registration Successful! Thank you for registering. We'll be in touch with you soon with more details about the event.
