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Contact Information

Nickname
Date of Birth*

*When entering date of birth, please do not add extra 0's and use a two-digit year, for example, 4/2/75.

Country*
State / Province*
Address*
City*
*
*
*
*
*
*
Email*
Confirm Email*
Phone*
Church*

Class Location

If you are unable to attend classes one of the sites listed above, please submit a live stream inquiry form.

Acknowledgement

I acknowledge that the Empower Proclaim program is a full year commitment, and that no refunds will be given. 

 

I understand that Empower classes in the Manhattan location will be live streamed, and I give permission to appear on camera as a class participant.

 

I have completed EmpowerOne and received a certificate.

Signature

Empower Proclaim Registration

Quantity
Price
Total
Empower Proclaim Registration

This $300 fee covers your course registration and January retreat. Please only enter a quantity of 1.

X
$
400.00=
$
0

Payment Information

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