Encounter God Retreat

Personal Information

First Name *

Preferred Name

Middle Name

Last Name *

Phone Number *

Email Address *

Date of Birth *

Gender

Additional Information

Life Group Leader *

How long have you been Born-Again? *

Year *

Have you been water baptized? *

Year *

Have you experienced the Baptism in the Holy Spirit? *

Year *

Please share a brief expectation about attending the retreat: *

Media Consent

Photos & Videos are regularly taken and used by IWC for ministry and promotional purposes.

Press "I consent" below to grant permission for the reasonable use of pictures and videos containing your child(ren) in promotional material, in-house graphics, social media posts, and on the website. *

I consent.

I do not consent.