Church Registration Form

Walk Thru the Bible:  Old Testament Seminar (for youth age 12 through adults)

Mar. 20, 2010 9-4pm hosted by New Richmond United Methodist Church

Name of Church Attending ______________________________      City Church is located in:_____________________________

Contact Person Name:___________________________________     Contact Email Address______________________________

Contact Person’s Address________________________________       Contact Person’s Phone (     )_____-__________

Registration Deadlines & Per Person Fees

Early Registration by Feb. 15, 2010:  $20.00 per person    Registration after Feb. 15, 2010:  $25.00 per person                 

                   Name of Participant                                  Address                                    Home Phone                  Email                                                     

1.      _________________________________________________________________________________________________________          

2.      _________________________________________________________________________________________________________

3.      _________________________________________________________________________________________________________

4.      _________________________________________________________________________________________________________

5.      _________________________________________________________________________________________________________

6.      _________________________________________________________________________________________________________

7.      _________________________________________________________________________________________________________

8.      _________________________________________________________________________________________________________

9.      _________________________________________________________________________________________________________

10.  _________________________________________________________________________________________________________

Please ensure ALL participants are included in the Church Registration Form       

Total of Participants _________x $_____per person = $__________Total registration fee enclosed.

               (Full Payment is required with registration)  Make checks payable to:  New Richmond United Methodist Church                                                                                                                                                                                                                                                                                                                                                                                                             (Please put “Walk Thru the Bible” in memo line.)

Mail Check with Registration Form & Permission/Medical Forms for youth under age 18 to:

New Richmond UMC (WTB)      209 E. 2nd Street      New Richmond, WI 54017

For Office Use:  Check #________Date_________ Amount  $_________