Church of Christ Ladies Lectureship-Retreat

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Register Online Registration Atlanta Teens Sponsors
Contact Us 2011 Community Donation Info

Pay On-Line Registration Form

Please Complete All Information!

Don't forget to follow both steps to pay online!  Your registration will not be processed until fees are received.  Do not use this method unless you are paying by credit card through Paypal.  Adult Registration fee is $179.00, Youth Registration fee is $169.00. This includes a $4.00 Paypal processing fee.
  • Please provide the following contact information:
    First Name
    Last Name  
    Middle Initial
    Street Address  
    City  
    State  
    Zip  
    Congregation
    Work Phone  
    Home Phone  
    Cell Phone  
    E-mail

Select all of the following options that apply:

Married            A Minister's wife  An Elder's wife    A Deacon's wife  
Widow              Divorced           Single             Single Parent
  Youth  (Age) 

Choose your shirt size        

Do you plan to attend the Friday AM Session? 
Have you made reservations? 
Did you attend the 2011 retreat? 
Referred by:  
If not, please do so.  Rooms tend to reserve quickly. Remember, you can always cancel.  

 Anticipated Arrival date.

Method of Payment  Name On the Card!
   

Webmaster: Paul White Jr.
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Revised: 02/04/12