Recharge 2024 - Participant Registration
Recharge
Participant Registration
September 27 - 28, 2024
Church Information
Church City
Church Name
My church is not in the list
Church Name
Church City
City ID
Church ID
Today
Will your senior pastor be attending?
Yes
No
Do you have a senior pastor discount code to apply?
Yes
No
Senior Pastor Discount Code
SP Code Valid
Will you be registering any students?(High School, College, Graduate, Seminary)
Yes
No
Do you have a student discount code to apply?
Yes
No
Student Discount Code
Student Code Valid
Point of Contact Information
Registration
$
Apply Discount
First Name
Last Name
Email
Cell Phone
Are you a senior pastor?
Yes
No
Are you a student?
Yes
No
T-shirt size (
NOTE: Sizes are subject to availability after September 14, 2024.)
Small
Medium
Large
X-Large
2X-Large
3X-Large
4X-Large
Count
Discount
Senior Pastor Information
Registration
$
First Name
Last Name
Email
Please enter a unique email address. If you don't know the email address, please leave blank.
Cell Phone
T-shirt size
Small
Medium
Large
X-Large
2X-Large
3X-Large
4X-Large
Count
Discount
Do you need to register additional people?
Yes
No
Attendee Information
Registration
$
Apply Discount
First Name
Last Name
Email
Please enter a unique email address. If you don't know the email address, please leave blank.
Cell Phone
Dup Email?
Duplicate Email Text
Are you a student?
Yes
No
T-shirt size
Small
Medium
Large
X-Large
2X-Large
3X-Large
4X-Large
Count
Discount
Volume Discount Code
Volume Discount
Payment Page
Hidden Totals
Total Registrant Count
Raw Total
Total with Discounts
$
Total Discounts Applied
$
Payment Type
Credit Card
eCheck
Check
Registration Summary
Subtotal
$
Total Discounts Applied
$
Total before card fees
$
Credit Card Fees*
$
Total Amount Due
$
Credit Card Information
Name on Credit Card
Credit Card Number
Credit Card Type
Please select...
Visa
Mastercard
Amex
Discover
Credit Card Code
(Card Verification Value)
Expiration Month
Expiration Year
eCheck Information
Bank Name
Name of Account Holder
Bank Routing Number
Bank Account Number
Account Type
Checking
Savings
Business Checking
Customer 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
Postal Code
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