REGISTRATION FORM Don't delay. It's as easy as 1 … 2 … 3!


Name (Mr/Mrs/Miss/Ps/Rev/Dr) Address


Phone/Cell Names & Ages of other Attendees: = Single


Couple (must be two from the same family) Family (three or more)


1 CONFERENCE REGISTRATION FEE


Includes all speaking sessions, shows & concerts and most onsite leisure activities. Qty


Cost


x$150 =$ x$250 =$ x$350 =$


Less Discounts -$ 1. SUB TOTAL =$


2 ACCOMMODATION PRICES (Children under 12 FREE in parents’ room) Beautiful hotel style rooms—serviced every day. (4 nights req. for the whole conference). Room Size


Single or Double Room Triple Room Quad Room


No. of Nights No. of Rooms Cost x$90 x$100 x$110


x x x


=$ =$ =$


2. SUB TOTAL =$


Book before March 31, 2012 and deduct the following amounts.


bird discount less $25


Early


less $30 less $35


Extra discount


Subscribers to Creation magazine or Journal of Creation receive an extra $25 off your total


Registration Fee. Pastors, active military, full time college or seminary students take an additional $15 off (total $40!)


Ridgecrest requires offsite attendees to pay $12 per person for 1 day, or $25 for 2 days or more as a facility use (includes onsite activities). or NOT STAYING ON CAMPUS?


No. of people 1 day @ $12pp


2 or more days @ $25pp Cost =$


2a. SUB TOTAL =$ 3 MEALS*


Add a meal plan. Including breakfast, lunch, dinner and all coffee breaks. Age


Adult & Youth (12yrs & up) Children (6-11yrs)


Children (5yrs & under)


x x


x


Weekly price No. of People Cost $120 $60


=$ =$


FREE – 3. SUB TOTAL =$


If you want more free leaflets to help publicize this faith-building event, please specify amount here


[ ] Please find enclosed my check OR Please charge my [ ] Visa


Card no:


Sub totals 1 + 2 (or 2a) + 3 =$ TOTAL DUE =$


Bring a Church Group—


DISCOUNTS APPLY! Contact Us.


[ ] Mastercard [ ] American Express [ ] Discover Expiry date: (last 3 digits on the reverse side, or 4 digits on the front of Amex cards) Verification digits:


Payment herewith for [ ] Full amount as shown above OR [ ] Charge my card in 4 equal monthly installments Signature


8


CANCELLATIONS: Refund requests must be made in writing and sent to f.bates@creation.info. Refund requests received by June 30, 2012 will receive a full refund minus $50. No refunds granted after June 30, 2012.


Limited RV and campsites available—contact us!


“My knowledge has increased, but not


nearly as much as my heart & soul have been blessed!”


*Please inform us of any


special dietary


considerations for yourself or your family.


REGISTER ONLINE AT CREATION2012.COM OR post to: CMI-US, PO Box 350, Powder Springs, GA, 30127 OR phone 1-800-616-1264


City Email State Zip


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8