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Program Registration

You can register here online for any of our classes or program events.  If you are attending with your spouse, you can register them on the same page.  Please note not all of our events offer childcare, however for those that do, please select the childcare box if you have this need. 

Payment can be made online or you can submit your payment directly to New Genesis Inc. at 1340 Cobb Ave. Kalamazoo MI 49007

Classes / Events::
First Name:
Last Name:
Spouse Name (if attending)
Age if youth:
Address Street:
City:
Zip Code: (5 digits)   MI
Childcare? Yes   No
Child(ren) Ages:
Home Phone:
Email:
Alternate Phone:
Type of card:   Expires:
Credit Card Number 
Comments:    

Contact Information

Please help us better understand your areas of interest by taking a few moments to fill in the information below.   *Required information

*Area(s) of interest:
*First Name:
*Last Name:
*Address Street:
Company / School/Org:
*City:
*Zip Code: (5 digits)  MI
Home Phone:
Alternative Phone:
*Email:
Comments:

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