METRO CHRISTIAN CONVENTION – March 26, 2011

Registration Form

Please PRINT legibly or TYPE. Give complete names and addresses.

EARLY REGISTRATION DEADLINE: Received or Postmarked by March 14, 2011

Last Name:________________________________________ First Name ______________________________

Street:____________________________________________________________________________________
City:__________________________________________________ State _________ Zip ________________
E-mail Address:____________________________________________________________________________
Home Phone #:________________________________ Cell Phone #:_________________________________
Home Church or Organization:_________________________________________________________________
PLEASE LIST THE NAMES OF REGISTRANTS WHO WILL ATTEND:
(Name badges will be printed in advance with this information.)
Check box if ordering lunch. If a minor please give:
($6.00 per person) Age Grade
__________________________________________ ❏ __________ __________
__________________________________________ ❏ __________ __________
__________________________________________ ❏ __________ __________
__________________________________________ ❏ __________ __________
__________________________________________ ❏ __________ __________
__________________________________________ ❏ __________ __________
__________________________________________ ❏ __________ __________
Total number of people registered on this form:____
Total number of lunches ordered: __________

REGISTRATION FEES:
On or before March 14: □ Individual $10 □ Family $20
After March 14 or at the door: □ Individual $15 □ Family $25
Registration amount paid with this form: $__________
Lunches: $6 x total number of lunches ordered ________ = $__________
Love gift or additional support for the Convention: $__________
Total amount enclosed: $__________

Make checks payable to “Community Christian Church” Do not send cash. No refunds can be given.

Mail to Russell Kraft 87-10 51st Ave. #1P Elmhurst, NY 11373