amazing love healing ministry

Event Registration

Payment instructions will be provided after pressing the Register button.  Please fill in all the required fields.

* Required Fields

Please know that we do not share out any personal and/or address information.  All personal data are stored OFFLINE.  Nothing can be accessed online. If you still have concerns about supplying personal information and would like to register, please contact me directly.

Photos are taken at some of our events.  By registering for this event you are giving consent for photos to be taken and used in our website's Photo Galleries.

EVENT INFORMATION  
Event Name
Event Date
Registration Type *  
Event Fee USD
Payment Type *  
   
PERSONAL INFORMATION  
First Name   (Enter both names if registering as a Couple)  *  
Last Name  *  
   
Gender *  
Year of Birth  *  
Email Address  *  
   
Address  *  
 
City  *  
State / Province  *  
Zip / Postal Code  *  
Country  *  
   
Telephone
Cell phone
   
Church  Where you are a member or attend
Devotionals
If you are human leave this field empty
OTHER INFORMATION  
Physical & Dietary Needs; Other Info
Please specify Vision, Hearing, Mobility or other Health concerns. Note any Dietary Needs (Medical only).  Specify any other information / requests.
How did you hear about this Event?
   
   

Please press the Register button only once.  The process may take a couple of seconds to complete.  The Registration will not proceed if required fields are missing.

“Bring the Love, Healing, and Reconciliation of Jesus Christ to all people.”