Couple’s Conference Registration Form Couple's Conference Event Registration Form To register for GTHM's Couple's Conference please submit the form below. Conference will be held on Friday, October 9th 6:30pm to 9:30pm and Saturday, October 10th 8:30am to 12noon. The cost is $45 per couple (cash or check) which will be collected at time of admission. (Registration deadline is Tuesday, October 6th, 2015.) For more info please contact Pastor Rod Lott. His Name* First Last Her Name* First Last His Email* Her Email* Primary Phone*What is the curent status of your relationship?*MarriedEngagedDatingSeparatedHave either of you been married before?Yes (Him)Yes (Her)Yes (Both of us)No (Neither of us)Do either of you have children?*Yes (Him)Yes (Her)Yes (Both of us)No (Neither of us)Do either of you have children from a previous relationship?*Yes (Him)Yes (Her)Yes (Both of us)NoWhat are you hoping to gain from attending this conference?*Relational EnrichmentRebuilding Trust After BetrayalLearn How To Resolve ConflictLearn How To Negotiate Win-Win SituationsStrengthen Commitment To RelationshipPlease explain any special concerns: Δ
