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Seminar Registration

2024 Seminar Dates

	Winter Session	Spring Session	Summer Session	Fall Session
Part 1	Jan 5-7	Mar 1-3	Jun 7-9	Sep 6-8
Part 2	Jan 18-21	Mar 14-17	Jun 20-23	Sep 19-22
Part 3	Feb 2-4	Apr 5-7	Jul 19-21	Oct 25-27

"*" indicates required fields

Seminar Attendee Information

Name of Seminar Attendee*

First Last

Email*

Cell Phone*

Mailing Address of Attendee*

Street Address City State ZIP Code

Are you (the Attendee) a Veteran or 1st Responder?*

No

Yes - I am a Veteran or 1st Responder

Select One of the Following*

I will be attending the seminar

I am sponsoring someone else

Seminar Information

PLEASE NOTE: Due to the experiential nature of The Road Adventure, social distancing is not possible during your experience. By choosing to begin, continue, and conclude your experience at The Road Adventure you understand and accept that social distancing is not possible and that you agree to assume and accept all risks and liabilities accordingly. Masks are optional.

Seminar Options and Dates*

Part 1 ($100) - Jan 5-7, 2024

Part 1 ($100) - Mar 1-3, 2024

Part 1 ($100) - Jun 7-9, 2024

Part 1 ($100) - Sep 6-8, 2024

Part 2 ($250) - Jan 18-21, 2024 (Part 1 must be completed)

Part 2 ($250) - Mar 14-17, 2024 (Part 1 must be completed)

Part 2 ($250) - Jun 20-23, 2024 (Part 1 must be completed)

Part 2 ($250) - Sep 19-22, 2024 (Part 1 must be completed)

Part 3 ($175) - Feb 2-4, 2024 (Part 2 must be completed)

Part 3 ($175) - Apr 5-7, 2024 (Part 2 must be completed)

Part 3 ($175) - Jul 19-21, 2024 (Part 2 must be completed)

Part 3 ($175) - Oct 25-27, 2024 (Part 2 must be completed)

Seminar Options and Dates (for Veterans & 1st Responders)*

Part 1 ($100) - Jan 5-7, 2024

Part 1 ($100) - Mar 1-3, 2024

Part 1 ($100) - Jun 7-9, 2024

Part 1 ($100) - Sep 6-8, 2024

Part 2 ($200) - Jan 18-21, 2024 (Part 1 must be completed)

Part 2 ($200) - Mar 14-17, 2024 (Part 1 must be completed)

Part 2 ($200) - Jun 20-23, 2024 (Part 1 must be completed)

Part 2 ($200) - Sep 19-22, 2024 (Part 1 must be completed)

Part 3 ($125) - Feb 2-4, 2024 (Part 2 must be completed)

Part 3 ($125) - Apr 5-7, 2024 (Part 2 must be completed)

Part 3 ($125) - Jul 19-21, 2024 (Part 2 must be completed)

Part 3 ($125) - Oct 25-27, 2024 (Part 2 must be completed)

Have you (or attendee if you are sponsoring) previously attended The Road Adventure?

No

Yes

Approximately what year did you attend?*

What program part(s) did you attend?*

Note: All registrations must be completed and a non-refundable down-payment paid in full 10 days prior to the start of the Part 1 Adventure you wish to attend.

Sponsor Information (If Applicable)

If you are sponsoring and wish to personally register and pay for someone else’s Road experience, IT IS EXPECTED that the person you are sponsoring is aware of the fact that you are sponsoring/registering them and that The Road Adventure office will be contacting them to welcome them and confirm their registration.

Name of Sponsor (If Applicable)

First Last

Sponsor's email address

Sponsor Phone (Contact Number)

Payment Section

Payment Method*

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number Expiration Date Security Code Cardholder Name

Total

Comments

This field is for validation purposes and should be left unchanged.

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MAILING ADDRESS

120 E FM 544, Suite 72, Box 337
Murphy, TX 75094

Phone: 972-690-5128

SEMINAR LOCATION

Lucas Fellowship Church
100 Stinson Road
Lucas, TX 75002

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