Onsite Leader Registration

Team Leader Name*

First Last

Email*

Phone*

Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Billing Address

Same as Mailing Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Birthdate*

Gender*

What makes you interested in using Rise Up for your group?*

Is this for a pre-existing group( sush as a Sunday School or Bible Study group)?*

How many people do you anticipate participating in this course?*

Please specify the makeup of the group.*

Please fill out any other information that you think would be helpful for us to know.

Rise Up Workbooks

Price: $15.00

Course Fee

Price:

1 Set of Rise Up DVDs will be shipped to you along with the workbooks. Please check and sign the statement below.

I understand that the Rise Up material is copyrighted. I hereby confirm that I will not copy or reproduce any of the Rise Up material without express written permission from the Rise Up office.

Signature

Date

Total

$0.00

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On-Site Registration