Registration for Children's Leaders Getaway at the Keeters Center on February 21-22, 2011 

Name

Email

Phone

Registration (Meetings only) for Individual   $20

Registration (Meetings only) for Couple  $30

Lodging with Registration & Meals for Individual

Room Choice

Lodging with Registration & Meals for Couple

Save $10.00 before December 20th  

Total for this Registraton $

Amount Paying with Pay Pal $

Amount Due by December 20th $

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