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Conference Registration Form 2008


CREDIT CARD REGISTRATIONS
For American Express/Discover/Visa/MC you may register on our Secured Server. (If you get the "Certificate Name Check" box in Netscape Navigator, click "Continue". If you get the "Security Alert" box in Internet Explorer, click "Yes".)

Or, you may call our office at:
(918) 743-0365 or
Fax your request to:
(918) 743-0484.

CHECK OR MONEY ORDERS
For checks and money orders you may mail your registration to:
Covenant Keepers, Inc.
3434 S Garnett Rd Ste One
Tulsa OK 74146

Name

Address

Additional Address

City

State/Province

Zip/Postal Code

Country

Telephone

E-mail Address

Visa/MC #

---

Expiration Date /

List only the names of the people you are registering.

Registrations on or before June 16th:
Adults and Teens (13-19) are $75, Pre-teens (10-12) are $45.

Registrations after June 16th
Adults are $110 Teens (13-19) are $75, Pre-teens (10-12) are $45.

Adult #1 First Name
Adult #2 First Name
Adult #3 First Name
Teen /Pre-Teen Name Age
Teen /Pre-Teen Name Age
Teen /Pre-Teen Name Age
Teen /Pre-Teen Name Age

    


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© 2006 Covenant Keepers, Inc., 3434 S Garnett Rd Suite One, Tulsa, OK 74146.
Phone: (918) 743-0365 - Fax: (918) 743-0484
All Rights Reserved.