Black Voices Gathering- Orange County, CA Remember answers on this browser? Stores your answers incase the browser closes. (Not recommended on public computers) Phone We are coming together again this August to let this gospel movement of the empowerment of Black voices take off across the globe. Fill out this quick form to let us know you'd like to be a part of the gathering. Let us know if you have any questions at: [email protected], or visit circuitriders.com/black-voices for more information. Important Note: If you're planning to go with the $200 Hotel Option for your accommodations, the $200 Housing/Transport Fee is due by Thursday, July 29th. We'll send you the link for payment upon completion of this form. Your Information: First Name * Last Name * Email Address * Phone * Age * Gender * Male Female In 5 sentences or less, how did you meet Jesus? Why do you want to take part in this weekend? What do you hope to take away from it? How did you hear about the Black Voices Gathering? Are you currently a university student? If so, where? Yes No Are you currently addicted to drugs or alcohol? Are you currently on any prescribed medication? If so, for what? (Your information is confidential to our team and helps us ensure the safety of all attendees) Housing options: Upon acceptance, please let us know which housing option you'd prefer. No payment is due now, this just helps us know how many hotel rooms we'll need to book. Please choose a housing option: I'll arrange my own accommodations Hotel for 3 nights $200 (Pay later) I'm married and we'll need our own room. (Pricing coming soon.)
