Dr. Richard Moore Registration
First Name
*
Last Name
*
Email Address
*
Mobile Number
*
Which nights will you be attending in person?
Monday (5/15)
Tuesday (5/16)
Wednesday (5/17)
Thursday (5/18)
Friday (5/19)
Watching Online
How many children will be coming with you (ages 0-11)?
None
1
2
3
4
5
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7
8
9
Names & Ages of Each Child (If Applicable)
Are you an ORDAINED as an apostle, prophet, evangelist, pastor, teacher, or the head of a ministry?
Yes
No
Who/what ministry/organization are you ordained under?
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