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Marriage Adventure Registration
You are registering for the June 10-12, 2022 Marriage Adventure in Kansas City, MO.
Please answer all questions and submit. We will be in touch soon with more details.
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* Indicates required question
Email
*
Your email
Name of Couple
*
Your answer
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zipcode
*
Your answer
Phone Contact
*
Your answer
# Years Married
*
Your answer
Please share one thing you and your spouse hope to gain from attending The Marriage Adventure Workshop.
*
Your answer
How did you hear about our workshop?
Your answer
Are you in need of financial assistance? The $75 deposit towards your registration will be due within 30 days of this registration. The remaining balance can be paid when you check-in on Friday of the workshop.
*
Yes
No
Maybe
We would like to arrive for early check-in on Thursday prior to the conference. We understand that there is an additonal room rental fee of $129.00 (conference room rate).
*
Yes, please register us for 3 nights (Thursday, Friday, & Saturday) for an additional $129
No, we will not arrive for early check-in.
Please mark t-shirt size for HUSBAND
*
S
M
L
XL
XXL
XXXL
Required
Please mark t-shirt size for WIFE
*
S
M
L
XL
XXL
XXXL
Do you have any food allergies that we need to be aware of? IF you answer yes, please specify your need in the next question. Check ALL that apply.
*
Yes
No
Gluten
Dairy
Other:
Required
Workshop Registration Deposit* Mark all that apply.
*
PayPal payment [click on link]
https://paypal.me/tomjoblack?locale.x=en_US
We will mail a personal check to 33680 107th Lane, Nelson, MO 65347
We have a Gift Certificate to apply to our overall cost
Option 4
Required
A copy of your responses will be emailed to the address you provided.
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