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Advance Registration

129.00 per person
--lunch included--

Registration Information

Name

Church

Address

City

State

Zip 

E-mail

(eg. example@mymail.com)

Telephone

Ministry Title

Location

Additional Names

Credit Card Information

Card Type

 Master Card     Visa     American Express

Card Number

 Exp. Date /

Name on Card

Security Code

 3 digit number on back of card

Billing Address

Cost

 I approve the 129.00 advance registration fee per person

Comments


 

Printable Registration Form for mail or fax (PDF)

Kidz Blitz Live

Big City Studio

Jim Wideman Ministries

Kidz Blitz
Curriculum

Cold Water Cafe

800.467.1711
UNCENSORED is sponsored by Kidz Blitz Ministries, Inc.
copyright 2006-2007 all rights reserved