Event Registration

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Re|engage Registration | WAITLIST | on Sunday, September 28, 2025

Price:

*Attendee's First Name:

*Attendee's Last Name:

*Attendee's Email Address:

*Attendee's Phone Number:

Country:

Address Line 1:

Address Line 2:

City, State Zip:

In an effort to serve you and your spouse well, please take a few moments to complete this form. We look forward to meeting you in person soon!

*His Name:

*His Birthday:

*His Cell:

*His Email:

*His T-shirt Size:

*Her Name:

*Her Birthdate:

*Her Cell:

*Her Email:

*Her T-shirt Size:

*Wedding Anniversary

*Is DBC your church home?

YesNo

If DBC is not your church home, where do you most regularly attend?

Please rate your marriage on a scale of 1-10 (10 being high)

*His Rating:

*Her Rating:

*I heard about re|engage from...

*Have you previously attended re|engage?

YesNo

*Where did you previously attend?

Please select all that CURRENTLY apply.

Military/Veteran

Separated

Divorced

Blended Family

Questions or Comments:

Backoffice

Please note that this registration is for both you and your spouse. We only need one registration submitted. Thank you!

Registration Total: