Request Information
Intimacy Weekend

Husband's Name *

First

Last

Wife's Name *

First

Last

Address *

Address Line 1

Address Line 2

City

County

Postal Code

Country *

Phone *

Email *

Comments

Your Personal Details (please choose) *

Yes - 2=1 may keep these contact details so we can be contacted by email (or other methods) with updates and invites to future courses/conferences and other events. Any prayer points and our attendance record will also be kept for the duration of the course only. We understand that 2=1 will not share our details with anyone else.
No - 2=1 may not keep these contact details after our potential course is finished.

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