discipleU registration form

After verifying that the information on the following form is correct, please click the submit registration button below and you will be redirected to our secure, online store.  Your registration is not complete until you have paid your registration fees.

First Name:    Last Name:

Address:    City:    State:    Zip Code: 

Home Phone:    Cell Phone:   Work Phone:   

Email Address: 

I would like to register for: 

 Doctrines of God and the Trinity (March 24 - June 2)

Child care registration:

Child1/Age: 
Child2/Age: 
Child3/Age: 
Child4/Age: 

How did you hear about Disciple U?:  FriendPosterBulletinWebsiteOther     Age Group:  Under 2020-2930-3940-4950-6464+     Gender:  MaleFemale

Additional comments or questions: