Prayer Summit Registration Form

    Full Name (required)

    Your Email (required)

    Phone Number (required)

    How many people are you registering? (required)

    Names of any other registrants (if anyone other than yourself)

    Any Dietary Restrictions for meals (if any)

    Any additional information you would like to provide. Please include any room-mate preferences. How you plan to Pay - Paypal/Credit Card or Check?

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    2015 Prayer Summit Payment

    Cost per person is $235.00, which includes a double occupancy hotel style room with private bath, eight meals and all summit sessions. A deposit of $50.00 is required to hold your spot upon registering. The balance is due by Feb 6, 2015.

    You can pay the balance a little at a time or all at once, as long as it is paid in full by due date.
    You can also pay by check via Mail or in Person to:
    Horizon Community Church
    2129 63rd Street
    Downers Grove, Illinois 60516.

    Paypal transaction fee is added automatically.
    Total Amount: