Believe in a

Miracle
A day of renewal for women
Saturday, February 20, Holy Trinity Episcopal Church, Clearwater
OR Saturday, February 27, 2010 Good Shepherd Episcopal Church, Punta Gorda

9 a.m. to 3 p.m. Lunch included

Advance registration required

First Name (as it will appear on Name Badge)_________________________________________________

Last Name_____________________________________________________________________________

Address_______________________________________________________________________________

City______________________________ State_______________ Zip______________________________

Phone ____________________________ Email_______________________________________________

Church you attend: _____________________________________City ______________________________

Day attending: Clearwater location: Saturday, Feb. 20 OR

 Punta Gorda location: Saturday, Feb. 27, 2010
The same program is being repeated each Saturday; please choose only one date to attend.

List special needs if any here:___________________________________________________________________

Please make checks payable to Believe In A Miracle 2010

COST IS $15 PER PERSON, non-refundable
Mail one form per person and a check to:
Believe In A Miracle
Box 1379 New Port Richey, FL 34656

Note: One check may be sent to cover multiple forms.

You will receive by mail a confirmation card which will include your name tag. This is your
admission ticket; please keep it in a safe place and wear it the day you attend.
Registration Deadline is Jan. 15, 2010. Space is limited; register early.
For Registration questions please contact: The Rev. Sandy Jamieson at 727 441-4686