RA 2024 Registration Adult First Name Adult Last Name Badge Name eMail Address Phone Number Address City State Zip Adult First Name Adult Last Name Badge Name Home Church Name [RA Host church: Parkway CC members receive a reduced adult registration fee of $25. Thank you for serving the region through your congregation!] Do You Need Translation YESNOWhat Language? Nursery (4 years old and younger) Children (5 To Age 12) Youth (13-18 Yrs Old)Full Name Badge Name (First Name) Age Full Name Badge Name (First Name) Age Full Name Badge Name (First Name) Age If you have 4 or more nursery/children/youth, please write full name, badge name (first name) and age in this section for each. REGIONAL ASSEMBLY FEES BY: APRIL 1st [ATTENTION: You will enter these numbers again on the payment page once you have submitted this registration form.]# of Adults by 4/1: $50 each [Parkway CC: $25] # of Nursery/Children by 4/1: $25 each # of Youth by 4/1: $35 each REGIONAL ASSEMBLY FEES AFTER: APRIL 1st# of Adults after 4/1: $60 each [Parkway CC: $25] # of Nursery/Children after 4/1: $35 each # of Youth after 4/1: $45 each REGIONAL ASSEMBLY FEE - FAMILY OF 4 or MORECLERGY/SPOUSE DINNERMaximum Family Cost BY 4/1: $150 Maximum Family Cost AFTER 4/1: $170 Cost: $35 each IF YOU ARE MAKING A DONATION FOR THE SCHOLARSHIP FUND OR TO SUPPORT THE REGIONAL ASSEMBLY YOU WILL MAKE THAT DONATION ONCE YOU SUBMIT THIS FORM.Attending and Scholarship Request Request consideration for scholarship assistance for Regional AssemblyEnter Scholarship Dollar Amount Attending and Donate Funds Donate funds for scholarships to help others attend Regional AssemblyEnter Scholarship Donation Dollar Amount Not Attending - Support Regional Assembly I cannot attend but would like to help support the Regional AssemblyEnter Regional Assembly Donation Dollar Amount SATURDAY WORKSHOPS [Please indicate number of attendees per workshop, per session.]11:00 a.m. - 12:00 p.m. WorkshopsChris Dorsey, DHM: "Building and Sustaining Authentic Community” Rev. Gregg Kaufman: "Deliberative Dialogue—A New Way of Talking Across Differences Selys Rivera: “The Advocating Church: Starting a Social Justice Project and Loving Like Jesus” 1:30 p.m. - 2:30 p.m. WorkshopsRev. Michael Junkroski: "Church Tech on a Shoestring” Sekinah Hamlin, Global Ministries: “Beyond World Communion Sunday and Pentecost” Rev. Day Broers-Case and Rev. Margaret Marquis Hambuch: "Your Pastor Has to Take Boundary Training - What's That About?" [This workshop is open to clergy and lay people. It does NOT meet the requirement for training for clergy with standing.] Dr. Charisse L. Gillett, President from Lexington Theological Seminary: “Equipping the Spirit for Ministry” T-SHIRT ORDERS - NOTE: T-shirts ordered after April 9th are subject to availability.You may pay for your t-shirt online or at the Regional Assembly by credit card or check.Cost: $20 Each - Youth and Adult sizes S-XL // Cost: $25 Each - Adults sizes XXL-XXXXLYouth - Small Youth - Medium Youth - Large Youth - XL Adult - Small Adult - Medium Adult - Large Adult - XL Adult - XXL Adult - XXXL Adult - XXXXL CommentSubmit
