Deeper Weekend Registration Form for Couples

Online application form for Couples. If you are clergy, please click here.

Please do not submit an application form more than once. If you need to change your Weekend choices, please call 909-332-7309 and we will be happy to assist you in selecting another Weekend.

English Regions are listed in PURPLE
Spanish Regions are listed in ORANGE
Korean Regions are listed in GREEN
Region/Encounter:

Weekend:

First Names Husband's first name: Wife's first name: Last name: Preferred Names (for name tags) Husband: Wife:

Contact Information Street address: Street address (cont.): City: State/Province: Postal code: (USA or Canada) Primary email: Alternate email: Primary phone: (XXX-XXX-XXXX) Alternate phone: (XXX-XXX-XXXX)

Original Weekend & Kickoff Dates Original Weekend date: (MM/DD/YYYY) 1st Kickoff Date: (MM/DD/YYYY) 2nd Kickoff Date: (MM/DD/YYYY)

Additional Information Wedding date: (MM/DD/YYYY) Special needs and/or requests: Travel by:

Conditions

I have read the Online Registration Agreement and accept the terms:

The Deeper Weekend

Deeper Weekend Registration Form for Couples