Church of God
Women’s Discipleship
Registration Form

Registration
$20.00 per person for Friday & Saturday
$7.00 Attending Friday Night Only
$15.00 Attending Saturday Only

To register, either fill out the form below and mail to
8600 William Ficklen Dr., Charlotte, NC 28269
or fax to (704) 717-0512
or call Lisa Sloop at (704) 717-0506, ext. 221
Deadline for registration April 9 th. Non-Refundable.

Church Name __________________________ Contact Name _________________________
Email _________________________________
Address _______________________________
City ___________________ Zip ___________
Phone _______________________
I speak Spanish. Please reserve a translation headset for me for Friday evening. YES ______ Reserve a “lite lunch” for me on Saturday. YES _____ Reservation to ride van to event $3.00/person YES_____
Please provide a list of names below:
_________________________ ___________________________
_________________________ ___________________________
_________________________ ___________________________
_________________________ ___________________________

You will receive an email confirmation or card in the mail once your payment has been received. Thank you!