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FALL REGIONAL CONFERENCE REGISTRATION - October 7-9, 2019 Lewis and Clark Bible Church
IF YOUR REGISTRATION IS LATER THAN September 30, 2019, PLEASE CALL (503) 325-7011 INSTEAD OF USING THIS FORM
Please enter name(s) below as you want them to appear on your name tag(s)*
Complete USPS Mailing Address*
Email Address for Registration Confirmation*
Phone # where you can be reached*
Church or Ministry you represent
Names and ages of children needing Child Care (5 yrs and under, during conference sessions only)
Need a Display Table? -- Reserve a table call (503) 325-7011
Meals - PLEASE MAKE RESERVATIONS for MONDAY EVENING DINNER, TUESDAY NOON LUNCH and TUESDAY EVENING DINNER AT THE CHURCH -- breakfast meals on your own with some food items Tuesday and Wednesday mornings before sessions. The Church generously will be covering the cost of your meals, so please register. There will be an opportunity to give towards the costs if you so desire.
# of MONDAY EVENING DINNERS [costs covered by the church]
# of TUESDAY LUNCHES & BREAK TIMES [costs covered by the church]
# of TUESDAY DINNERS [costs covered by the church]
REGISTRATION of $25 PER PERSON (except children) covers Regional costs, but is NOT REQUIRED FOR CONFERENCE ATTENDANCE. If you cannot afford this fee, leave this line blank. An offering will be received on Tuesday night to help cover the cost of those who cannot afford this fee. PLEASE DO NOT ALLOW FINANCES TO KEEP YOU AWAY
Total Registration Fees
TOTAL to be remitted for MEALS and REGISTRATION
Indicate your Payment Option*
 On Line (https:/nicechurchplanters.org/donate)
 Expect a payment check from my bank 
 I will mail a check to Lewis and Clark Bible Church
 Upon arrival - payable to Lewis and Clark Bible Church
To pay online go to https://nicechurchplanters.org/donate

Click on “General Administration”

Under “add a note” indicate regional registration.

If paying by mail, make checks payable to Lewis and Clark Bible Church and mail to the church at
35082 Seppa Lane
Astoria, OR 97103



YOU WILL RECEIVE E-MAIL CONFIRMATION of your registration a few minutes after submitting it, and an acknowledgement from the host church within a few days. IF YOU DO NOT RECEIVE AT LEAST ONE OF THESE, PLEASE RESEND YOUR REGISTRATION.


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