Register by March 23, 2001, and take the early registration discount. Use a separate form for each adult registrant and each youth registrant (ages 13-18). For each youth registrant, please include the name of an adult sponsor (a parent or other adult who will be attending the conference). Children, 12 and under, should be registered on an adult's form. PLEASE PRINT
Registrant
Adult Youth : Sponsor __________________________________________ | |
Name (for name tag) | _______________________________________________ |
Address | _______________________________________________ |
City, State, Zip | _______________________________________________ |
Phone | (_____)________________________________________ |
_______________________________________________ | |
Your congregation | _______________________________________________ |
Workshop Registration
A: 10:20-11:45 a.m. | B: 1:30-2:45 p.m. | C: 3:00-4:15 p.m. |
1st choice : A ___ | 1st choice : B ___ | 1st choice : C ___ |
2nd choice : A ___ | 2nd choice : B ___ | 2nd choice : C ___ |
Special Needs
I need Home Hospitality lodging. |
Put me on the "want roommate list" and send me a copy. |
I have special meal requests (specify): |
I need other special assistance to participate in the conference (describe):
____________________________________________________________________________________ |
Table Topics: At
breakfast on Saturday and Sunday, you'll have
opportunities to sit and talk with others interested in discussing a common topic.
If you have an idea for a Table Topic, please note it here and provide the name
of a person attending the conference who is willing to lead the discussion:
____________________________________________________________________________________
Child Registration: Your registration must be postmarked no later than March 23, 2001, to be eligible for child care. Child care with age-appropriate activities for children 12 and under will be provided for a fee of $32 per child. Care will be available Friday 6:45 - 10:00 p.m.; Saturday 9:00 a.m. - 10:00 p.m.; Sunday 9:00 - 10:30 a.m. Fee includes Friday evening snack, lunch/dinner/snacks on Saturday and snacks on Sunday.
Child’s name: ___________________________________________ Age: _______ |
Child’s name: ___________________________________________ Age: _______ |