Conference & Seminar Registration Form

Registration Fee Is $30.00 Per Event

 

First Name

Last Name

Address

City, State and Zip

Phone #

Email Address

How did you hear about us?

I am registering for the following:

Holy Ghost Boot Camp
Break The Chains
Weight Loss Seminar
Women's Seminar
Men's Seminar

Additional Comments

Method Of Payment

I am mailing in the payment.
I am making payment online.