Living Proof Registration

Living Proof 2008

Registration Form

* = Required

Name of Church:

*Your Name:

First Last

*Your E-mail:

(Used to send you a confirmation)

*Your Phone:

Day Evening (Enter in form xxx-xxx-xxxx, ex. 240-553-1090)

*Your Address:

Street

City State Zip Code

Special Needs:

*Number of Tickets

Qty. x $40 = $

How did you hear about the event?

Attention:

Please Read

Online Registration requires payment. Clicking on the submit button will take you to
PayPal. From there you can choose to pay using a PayPal account (if you have one) or
continue on using a credit card. If you are not ready to pay, then do not submit this
registration form at this time.

Required: Type the characters in the image above