WICHITA QUAKE

Group Information

Registrar Name

Registrar Email

Registrar Cell Phone Number

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Group Leader's Name

Group Leader Email

Group Leader Cell Phone Number

Church Phone Number

Church Name

Church Address

What Denomination is Your Church

How Did You Hear About Quake?

Registration Items

Middle Schoolers (Late)

$159.00/ea.

High Schoolers (Late)

$159.00/ea.

Adult Leaders (Late)

$159.00/ea.

Call (920) 202-3126 for hotel room inquiries. Rooms are not guaranteed after the Standard deadline.

Order Total

$0.00

Add a Donation

Donation Amount

Suggested Amounts

$100
$500
$1,000
Other

What fund would you like your donation to go towards?

Quake Ministry
General Life Promotions Fund

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