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Date*

Name*

First Name Last Name

Are you married?

Yes, I am married

Spouse's Name

Phone Number*

Email Address*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Names, Ages of Children & Youth (at family week)

Accommodations*

We will have a camper, motor home, etc

Find us lodging on campus or the community

Men’s Dorm

Ladies’ Dorm

We will be providing our own lodging

Number in Men's Dorm*

Number in Ladies' Dorm*

Please indicate the number of people from your family attending each session per class period.

Life-giving Relationships – Youth

Biblical Manhood – Men

Women of Purpose – Women

Anchors of Faith – Parents

Choir – Youth

"Go Ye Therefore…" – Youth & Parents

Distracted Disciples – Youth

Character Training (Ages 6-12)

Child Care (Ages 5 and under)

Handbook

Please Send us an SMBI Handbook

Note:

Family Week Registration Fee*

Price:

Payment Method*

Credit Card

PayPal

Credit Card*

Card Details

Cardholder Name

8074