Register

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

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.