Your Name
*
First Name
Last Name
Organization/Church Name
*
Your position in the Organization
*
Organization Phone Number
*
Country
(###)
###
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Organization Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Email Address
*
Confirm Email Address
*
Your Contact Cell
*
Country
(###)
###
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Event Name
*
Event Date(s)
*
MM
DD
YYYY
What type of event are you hosting?
*
Event Description
*
Tell us more about this event. The vision behind it, purpose for gathering, etc
Venue Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Event seating capacity
*
Estimated attendance of event
*
Other speakers/worship leaders confirmed for this event
*
Number of sessions you are requesting the worship leader to lead
*
Requested date
*
MM
DD
YYYY
Date option 2
*
MM
DD
YYYY
Date option 3
*
MM
DD
YYYY
Closest Airport to the Event City
*
Which leaders are you requesting?
Are you requesting:
*
Have you hosted a Life Center Worship Leader for a previous event?
*
Please write yes or no in the box below. If yes, please enter details of event such as worship leader, event name, event dates.
Additional Information
Your Sound Engineer Name
*
Your Sound Engineer Cell
*
Country
(###)
###
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Disclaimer 1
*
Please read and check that you have read disclaimer
Disclaimer 2
*
Please read and check that you have read disclaimer
Disclaimer 3
*
Please read and check that you have read disclaimer