Author: Hani

[Archdiocese Convention/[DIOCESE]
Parish Life Conference]
[DATES]
Hosted By: [HOST PARISH(ES) NAME]
[PHONE]
[EMAIL]
[WEBSITE]

Event Registration Form

Early Registration Deadline: [DEADLINE]

We encourage everyone to pre-register. Some events may sell out and will not be available at the [Convention]/[Conference].

First Name	Last Name	Birthdate / Ages 18 & under			Organization / Affiliation					Group					Packages			Individual Events / Incl. in Package					Additional Events / Not Incl. in Package										Fees		Total (USD)
Please Print Clearly how you want your name to appear on your badge / Anyone under the age of 18 MUST submit a completed and signed Minor Participation Form prior to / receiving their Badge. / Place an X in the appropriate boxes for each listed person.		Month	Day	Year	Antiochian Men	Antiochian Women	Order of St. Ignatius	Teen SOYO	Young Adul;t Ministry	Children (Ages 4-12)	Teens (Ages 13-18 Only)	Adults (Ages 19 +)	Clergy B/ishop, Priest & Deacon Only	Clergy Wives Priest & Deacon Wives only	Early Package	Standard Package	Kid’s Club Week Pass	Event 1	Event 2	Event 3	Event 4	Event 5	Additional Event 1	Additional Event 2	Additional Event 3	Additional Event 4	Additional Event 5	Additional Event 6	Additional Event 7	Additional Event 8	Additional Event 9	Additional Event 10	Processing Fee: Required for all 12+ who do not purchase an event	Mandatory Registration Fee / Ages 12 & older
1.																																			$
2.																																			$
3.																																			$
4..																																			$
5.																																			$
										Children																									TOTAL:
										Teens																									$
										Adults
										Clergy
										Clergy Wives

Name: ____________________________________________
Address: __________________________________ City, State/Province, Zip Code/Postal Code: ________________________________________
Telephone: __________________________ E-mail: ___________________________ ______ Diocese: _____________________________________________________________________
Parish Name: ______________________________________________________________________________________________ Parish City: _____________________________ Parish State/Province: ______________

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