Convention Registration Form

Please complete the form below. Fields marked required must be filled.

If you do not have a phone number, please provide a reachable proxy contact number we can use to get in touch with you.

Camp fee: N1,000 and N250/Child. Payment can be made after form submission.

Registration Type

Individual Details

Initial

First Name

Middle Name (Optional)

Surname

Age

Phone

Family Details

Enter husband details, wife details, or both. At least one spouse is required for family registration.

Husband Section

Husband Initial

Husband First Name

Husband Middle Name (Optional)

Husband Surname

Husband Phone

Husband Email (Optional)

Husband Age

Wife Section

Wife Initial

Wife First Name

Wife Middle Name (Optional)

Wife Surname

Wife Phone

Wife Email (Optional)

Wife Age

Number of Children

Email (Optional)

Total Fee: N1,000

Church

Address

City

State

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