Register

Register2019-06-06T08:07:57+00:00

If you’d like to be a part of the Arise 2019, please complete the form below.

First Name (required):

Last Name (required):

*Your Email (required):

Your Phone (required):

I Am A: Senior PastorAssociate PastorYouth PastorLay PersonCollege PastorOther

Church Name:

Church Address:

Church City:

Church State:

Church Zip Code:

Senior Pastor's Name:

Church / Sr. Pastor Email:

Church Phone:

Denomination/Affiliation:

*By providing an Email address, I give Teen Challenge of Southern California, Inc. permission to Email me in relation to this event.