Countdown Registration

Sign up for Countdown by filling out the information below.

His First and Last Name

His City and State

Her First and Last Name

Her City and State

Best Contact Information

Email Address

Phone Number

We plan to attend

Six week class including the retreat

Weekender (retreat only)

Individual sessions (one-on-one)

In the

Spring

Fall

Summer

What day of the week is the best option?

Sunday

Thursday

How did you hear about Countdown?

If Other, Please Describe

Additional Comments or Requests

Success! This form has been submitted. At your convenience, yet before the deadline, please complete both the Couple Information and the Marriage Investor forms. Pay online by debit/credit card or send a check to: Legacy Family Ministries 7574 FM 1123 Belton, Texas 76513 If you have any questions, please contact our office.