RCI is an initiative of the Potomac Ministry Network, designed to connect and resource pastors of churches in rural areas, especially those serving congregations of 100 or fewer.

Please note that space is limited to 25 couples/ churches. Priority will be given to first time attendees of Rural Compassion. The cost of the weekend is sponsored by Potomac Ministry Network and Convoy of Hope/Rural Compassion. The only cost for you will be to expenses for travel to and from the event. (There is a no-show fee of $150.)

Please remember to bring a van or large vehicle!

Registration Information

Have you attended a Rural Compassion Conference before? *

yes

no

First Name *

Last Name *

Address *

City *

State *

Zip *

Phone *

Email Address *

Will your spouse also attend? *

Yes

No

What is your spouse's name? *

Will you need childcare? (Available for ages 0 through 10) *

Yes

No

Childcare Information

Please provide the information below for each child that will be entered into childcare during the event. Thank you.

	Name	Gender	Age
Child One	Name	Gender	Age
Child Two	Name	Gender	Age
Child Three	Name	Gender	Age
Child Four	Name	Gender	Age

Payment Information

There is no charge to attend the Rural Church Initiative 2019 Conference. However, there is a $150.00 cancellation/no show fee. Your credit card will only be charged for cancellation/no show.

Thank you.

Name on Card *

Credit Card Type *

Credit Card Number *

Expiration Date (mm/yy) *