Prayer Ministries

Revive Us Again Prayer Conference & The Kids' Connection

Name

Address

Phone

Email

Select room type

Double Room - $265 per person (Includes meals and two nights in the Lied Lodge)

Roommate name (Payment will be included unless registered separately)

Roommate Name (Payment will be included unless registered separately)

Children and Youth Child (0 - 5 yrs) Child (6 - 11 yrs) Youth (12 - 17)

Name of each child or youth and age

Please call Miriam Dovald at 785-478-4726 to arrange payment.

Credit or Debit Card Will make other arrangements for payment.