women's conference registration

First Name
Last Name
Address:
City:
State:
Zip:
Phone:
Email
Special Needs: (Handicap, Signing, food, other)
Church Affiliation:
Emergency Contact Name:
Emergency Contact Phone:
Emergency Contact Relationship:

Women's Retreat Payment May 2-3, 2008

Women's Full Conference $95.00:

(All meals and sessions as noted on schedule)

Friday Conference Package $55.00:

(Dinner, Opening Session and Ice Cream Social)

Saturday Conference Package $60.00:

(Morning Coffee w/Pastries, Lunch and all sessions)

(If paying by check DO NOT click on Add To Cart button see below)

To Pay by check: print registration (using your browser)

and mail to:

Antioch Baptist Church

6531 Little Ox Rd

Fairfax Station, VA 22039

Attn: Women's Conference