Discipleship Leaders Retreat
Exhibitor Registration
Exhibitor Registration
Registration has reached capacity.
For any questions or concerns, please contact
Caitlin Merriman
.
Are you a Texas Baptists Staff Member?
Yes
No
Ministry/Company Information
Company/Ministry Name
Website
Address
City
State
Please select...
TX
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
UT
VT
VA
WA
WV
WI
WY
Zip
TXB Team
Type your Department name and select your department when it appears.
x
TXB Sub Team
TXB Name
TXB Address
TXB CIty
TXB State
Please select...
TX
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
UT
VT
VA
WA
WV
WI
WY
TXB Zip
TXB Email
Contact Information
This section is intended for the primary contact for your group, regardless of whether they will be attending the luncheon.
First Name
Last Name
Email
Phone
Title
Exhibitor Opportunities
Please select one.
Exhibitor Table Sponsor ($450)
• Logo in email blasts, insert in registration packets.
• Exhibitor space, one table.
• Breakfast and dinners at retreat, Tuesday lunch on your own.
• Logo/Website featured as sponsor on retreat webpage
Exhibitor Table Sponsor ($450)
• Logo in email blasts, insert in registration packets.
• Exhibitor space, one table.
• Breakfast and dinners at retreat, Tuesday lunch on your own.
• Logo/Website featured as sponsor on retreat webpage
Meal/Fellowship Sponsor ($650)
• Logo in email blasts, insert in registration packets.
• Exhibitor space, one table.
• Breakfast and dinners at retreat, Tuesday lunch on your own.
• 5 minute presentation in front of group before your sponsored meal/fellowship time.
• Logo/Website featured as sponsor on retreat webpage
Representative Information
Please provide the below information for the representative who will be attending.
First Name
Last Name
Email
Phone
Rep. Title
Will this representative need lodging?
Yes ($250)
No, they will be staying offsite.
Does this representative have any food allergies? (We will do our best to accommodate).
Yes
No
Please specify:
Will any additional representative be attending?
Yes
No
Additional Representative
Representative Registration ($50)
Will this representative need lodging?
Yes ($250)
No, they will be staying offsite.
First Name
Last Name
Email
Contact Phone
Representative Title
Does this representative have any food allergies? (We will do our best to accommodate).
Yes
No
Please specify:
Hidden
Additional Rep Count
Add Rep Cost
Additional Rep Total
Amount Due
$
Booth Counts
Level 2 selected
Level 2A selected
Level 3 selected
Booth Count
Total Rep Count
Sponsor Hidden
Level 1 Capacity
Level 1 Used
Level 1 Calc
Level 2 Capacity
Level 2 Used
Level 2 Calc
Level 3 Capacity
Level 3 Used
Level 3 Calc
Payment
Payment Type
Credit Card (3% processing fee applies)
eCheck
JE (10-61140-100-415-11527)
Hidden: Discounts
TXB Discount Code
CCH Discount
Get Discount
Registration Summary
Subtotal
$
Discount Applied
$
Total before CC Fees
$
Credit Card Fee*
$
3% added for credit card processing
x
Total Amount Due
$
Credit Card Information
Name on Credit Card
Credit Card Number
Expiration Month
Expiration Year
Security Code
(Card Verification Value / CVV / CSV)
eCheck Information
Bank Name
Name of Account Holder
Bank Routing Number
Bank Account Number
Account Type
Checking
Savings
Business Checking
Billing Information
First Name
Last Name
Email
Street Address
City
State
Please select...
AL
AK
AS
AZ
AR
CA
CO
CT
DE
DC
FL
GA
GU
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
MP
OH
OK
OR
PA
PR
RI
SC
SD
TN
TX
UT
VT
VA
VI
WA
WV
WI
WY
Zip Code
Authoirze.Net Hidden
Authnet_Hidden_Fields