Shine! Registration

Name

Age

T-shirt size

Home Church

This address will receive a confirmation email

Phone

Address

Payment $30.00

Food allergies (we will be having Chick-fil-a chicken sandwiches)

How can we pray for you?

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

February 21, 2026

Please fill out this form and click submit.