Order Number 2021 Wee Kirk Registration Participant Information First Name: * Last Name: * Email Address: * Are you bringing a spouse? * Yes No Church Information Church Name: * City: * State: * – Select Province/State – Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Average Church Attendance: * Presbytery: Housing Preferences Do you (or your spouse/roommate) have any special health needs or dietary restrictions? Please specify below: Track Selection PLEASE NOTE: The Barnabas Track has an additional fee on top of the main conference registration. First year participation is FREE; returning participants will be charged $50 for individuals and $75 for couples. Choose one track focus for your conference experience. * Barnabas Track – First Timer Barnabas Track – Repeater Missional Track Spiritual Formation Track Retreat Track IMPORTANT When you click on “NEXT STEP” you will be taken to our secure online payment system. Once there, ONLY click on the “RESERVE” button on the right-hand side of your screen. On the following screen, just fill out the REQUIRED fields (marked with an asterisk) and click the box to agree to the cancellation policy before making your reservation. Your reservation is not complete until you have submitted the payment form.