Church Group Registration- 2022

FQ 2023 Early Church Group Registration

Sign up for the minimum of 5 students to lock in the early bird price for next year. You can add more students as we get closer to FQ 2023.

Church Name*
Your Email*
Church Phone*
Church Mailing Address*
Unit #
City*
State*
Zip*
Leaders & Contact Info
Main Church Youth Pastor or Senior Pastor Name & Cell*
First Name Last Name Cell Number
Main Church Youth Pastor or Senior Pastor Email*
Onsite Youth Leader Name & Number | Wednesday, 6/28*
First Name Last Name Cell Number
Onsite Youth Leader Name & Number | Thursday, 6/29*
First Name Last Name Cell Number
Onsite Youth Leader Name & Number | Friday, 6/30*
First Name Last Name Cell Number
Estimated Total Number of Students Attending*
Select Tickets
FQ three-day conference registration rate per student*
*Pre-registering 5 or more students locks in early bird price for remaining students.
You must register a minimum of 5 students to complete this form.
Price: $47.00 Quantity:
FQ Free Youth Leader Registration***
**One FREE Youth Leader with 5 paid student Three-Day Registrations
Price: $0.00 Quantity:
FQ Three day rate for additional youth leaders
Price: $47.00 Quantity:
Total
$0.00
Credit Card*
Card Details
Cardholder Name