Rise Registration Form | The Road Map

Rise Encounter Registration Form

**This encounter is for Young Ladies, ages 14-17

on July 17th-21st, 2024.

Check in time is on Wednesday from 2:00 - 2:45 in Big Rapids. The event will end Sunday early afternoon.

*Deposit to hold your spot is $249.00 (deposit is non-refundable)

Cost of the encounter is $449.00, the full payment is due 3 weeks before the encounter starts unless other payment arrangements have been made.

**Scholarships are available if needed, please contact Lori at lori.theroadmap@gmail.com

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

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 ($)

Rise Deposit (Non-Refundable) - $249.00

Rise Registration - $449.00

Thank you for signing up for an Encounter. More information will be emailed to you.