Upcoming Events – FaithWalk Mid-South

Event	Beginning Date	Ending Date
CrossRoads Mid-South #14	Friday, January 15, 2021	Monday, January 18, 2021
FaithWalk Mid-South #85 - Men	Thursday, March 18, 2021	Sunday, March 21, 2021
FaithWalk Mid-South #86 - Women	Thursday, March 25, 2021	Sunday, March 28, 2021

Below, you will find the Registration form to attend a FaithWalk Mid-South weekend as a first time FaithWalk Believer. If you have attended a previous 4th day weekend such as Discipleship Walk, Tres Dias, Great Banquet, Walk to Emmaus, Chrysalis, Cursillo, etc., you are not allowed to attend FaithWalk as a first time believer, but may instead serve as a member of our FaithWalk team. If you have questions, please contact us.

By submitting this application, you are committing to attend a FaithWalk weekend, as designated by the registrar. If you are not certain that this is what you wish to do, please refrain from filling out this form. For more information, please see About FaithWalk.

Current Rates:
FaithWalk: $160.00 with an $80.00 deposit.
CrossRoads: $145.00 with an $72.50 deposit.

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Have you ever attended a 4th day weekend? (FaithWalk, Discipleship Walk, Tres Dias, Great Banquet, Walk to Emmaus, Chrysalis, Cursillo, etc)
NOTE: If you have ever attended a 4th day weekend you are not eligible to attend a FaithWalk Weekend, but may submit this form to register as a user on this site.
Gender*
For which type of weekend are you applying?*
- FaithWalk
- CrossRoads (Youth/Co-Ed)
We are currently unable to accept online applications for CrossRoads weekends at this time. Please click here to download the paper application. Thank you!

Believer Walk
Walk #
STOP! If you attended a FaithWalk Mid-South or CrossRoads weekend or if you have ever served on a FaithWalk Mid-South or CrossRoads weekend you should already have a profile in the system. You simply need to reset your password to gain access to the site. If your email address has changed and you need to update it, please send a message to Website Help using the Contact Us page.
Name
First Middle Last Suffix (Jr, Sr, etc)
Date of Birth*
MM
DD
YYYY
Address*
Street Address Address Line 2 City State ZIP Code
Phone-Cell*
Phone-Home
Phone-Work
Email*
Create your Password*
Enter Password Confirm Password

Smoker*
Shirt Size*
Marital Status*
Has your spouse attended FaithWalk or another 4th Day weekend?
Spouse's Name
First Last
Emergency Contact*
First Last
Emergency Contact's Relationship to You*
Emergency Contact Address
Street Address City State ZIP Code
Emergency Contact Phone*
Who encouraged you to attend?*
First Last
Encourager's Relationship to You
Encourager's Address
Street Address City State ZIP Code
Encourager's Phone*
Dietary Needs
Medical Needs
Do you have high blood pressure? Are you diabetic? Are you pregnant (If yes, what is your due date)?
Special Skills: medical training, musical abilities, etc.
Home Community
Cross Carried By
Table
Current Church Name*

Church Denomination*
How long have you attended this church?*
Pastor's Name*
Prefix First Last
Church Address*
Street Address City State ZIP Code
Church Phone*
Tell us how and when you came to know Jesus Christ personally:*
What are your regular habits of prayer and quite time?*
How do you feel about learning to disciple your peers?*
We need a reference letter from a Church leader or other adult, such as a small group leader or Sunday school teacher. Please provide us with the name of your reference.
Reference*
Title First Last Suffix (Jr, Sr, etc)
Reference Address*
Street Address City State ZIP Code
Phone*
Reference Email*

Deposit Receipt Date
Manual Payment 1 Amount
Manual Payment 1 Date
Manual Payment 1 Payer
Manual Payment 1 Method
Manual Payment 1 Check Number/Note
Manual Payment 2 Amount
Manual Payment 2 Date
Manual Payment 2 Payer
Manual Payment 2 Method
Manual Payment 2 Check Number/Note
Form of Payment*
Please choose how you would like to pay for your weekend.
Payment Amount
Convenience Fee
Price: $0.00
A convenience fee will be added to cover the credit card processing fees.
Credit Card*

Card Details

Cardholder Name
Total Payment Amount
$0.00
Registrations are on a first come, first served basis and this registration does not guarantee you a place on the upcoming Walk.
You will receive a confirmation notice from the Registrar approximately eight weeks prior to the Walk date.
Registrations are on a first come, first served basis and this registration does not guarantee you a place on the upcoming Walk. If you choose not to pay online, your deposit must be mailed in after completion of this online registration form. We cannot reserve your space until your deposit is paid.

Please make your check payable to: FaithWalk (Be sure to reference the name of the person attending the weekend on your check.)

Please mail your full payment or deposit to: FaithWalk Registrar, PO Box 51, Ellendale, TN 38029

You will receive a confirmation notice from the Registrar approximately eight weeks prior to the Walk date.
Profile Picture
By submitting this application online, you hereby release and agree to hold harmless CrossRoads and FaithWalk, it's Secretariat and the weekend servants from any and all liability regarding any claims for personal injuries and damage to or loss of personal property that I may incur during any activity sponsored by CrossRoads or FaithWalk. If under 18, a parent/guardian signature will be required at the time of checkin..

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We are currently unable to accept online applications for CrossRoads weekends at this time. Please click here to download the paper application. Thank you!