Restore Conference Registration

Name (First, Last):
E-mail Address:
Home Address:
Shirt Size (Adult S/M/L/XL/XXL):
Home Phone #:
Cell Phone #:
Emergency Contact (Name):
Emergency Contact (Relation):
Emergency Contact (Phone #):

If you are registering more than 1 person in the same household, please enter their information below:

If you are registering children: Please indicate the child's t-shirt size by writing in the correct size. (ie. 12mo, 4T, 5T, Youth S/M/L/XL, or if it is a child with an adult size, please write in "Adult S/M/L/XL")

Name:
	Adult Child
Child Age:
Child Attending Seminar:	Fri Night Sat Morning Sat Night
Shirt Size (Adult S/M/L/XL/XXL) - or Kid's:

Name:
	Adult Child
Child Age:
Child Attending Seminar:	Fri Night Sat Morning Sat Night
Shirt Size (Adult S/M/L/XL/XXL) - or Kid's:

Name:
	Adult Child
Child Age:
Child Attending Seminar:	Fri Night Sat Morning Sat Night
Shirt Size (Adult S/M/L/XL/XXL) - or Kid's:

Name:
	Adult Child
Child Age:
Child Attending Seminar:	Fri Night Sat Morning Sat Night
Shirt Size (Adult S/M/L/XL/XXL) - or Kid's:

* No online payments will be accepted.
* Please write a check out to Higher Connection Church or pay in cash at the connection table.

Peter Mun
Higher Connection Church
13421 Georgia Avenue
Silver Spring, MD 20906

© Higher Connection Church, All rights reserved.

Higher Connection Church
13421 Georgia Avenue
Silver Spring, MD 20906
Tel: (301) 460-1656 ext. 251
Fax: (301) 460-7925
Email: admin@higherconnectionchurch.org