Revive us, O Lord Registration

First Name REQUIRED Please fill out this field. Please enter valid data.

Last Name REQUIRED Please fill out this field. Please enter valid data.

City REQUIRED Please fill out this field. Please enter valid data.

State REQUIRED Please fill out this field.

Zip REQUIRED Please fill out this field. Please enter a zip code.

Email REQUIRED Please fill out this field. Please enter an email address.

Phone Number REQUIRED Please fill out this field. Please enter a phone number.

Parish, School or Catholic Institution: REQUIRED Please fill out this field. Please enter valid data.

I am: REQUIRED Priest Deacon Religious/Consecrated Lay Please fill out this field.

I serve my community in the capacity of: REQUIRED Clergy team member Parish lay minister School leader/employee Volunteer Please fill out this field.

Other (please specify) Please enter valid data.

I have led or participated in the following (check all that apply): Alpha Discovering Christ Following Christ Sharing Christ

Other small group evangelization effort(s) (specify) Please enter valid data.

Dietary restrictions: Gluten Free Dairy Free Vegetarian

Other dietary restrictions (please specify): Please enter valid data.

I would like to attend the conference virtually: REQUIRED Yes No Please fill out this field.

Payment REQUIRED 20.0 – I live, work, or serve in a parish or Catholic institution in the Diocese of Pittsburgh 75.0 – I do NOT live, work, or serve in a parish or Catholic institution in the Diocese of Pittsburgh Please fill out this field.