Heroes Reflect Registration

Heroes Reflect Encounter Registration Form

Check in time on Wednesday is between 5:30-6:00 PM in Big Rapids. The encounter will end Sunday early afternoon. More details will follow in the email you provide on this form.

Cost of the Heroes Return Encounter is $50.00. The full payment is due upon signing up unless other payment arrangements have been made.

First name

Last name

Street Address

Street Address Line 2

City

State

Postal / Zip code

Phone

Birthday

Emergency Contact Name

Emergency Contact Phone Number

Relationship to Emergency Contact

Emergency Contact Email

Are you Military (indicate branch), First Responder, Firefighter, or Spouse? Please indicate how many years of service as well.

Food Allergies

What is the name of your home church?

How did you hear about us? (If friend or church, please write the name)

Prayer Requests

Select an item ($)

Heroes Reflecct Registration - $50.00

Thank you for signing up for an Encounter. More information will be emailed to you at a later date.

Heroes Reflect Encounter Registration Form

3217 108th St SW Byron Center, MI 49315 Chuck- 616-291-6493 info.theroadmap@gmail.com

3217 108th St SW
Byron Center, MI 49315
Chuck- 616-291-6493
info.theroadmap@gmail.com