Knocking

May 4-6, 2012 Conference Registration

Janet Holm McHenry
Looking Up! Ministry

Life Empowered's 3rd Annual Conference
Be Still... Featuring Janet Holm McHenry

STEP 1: Registration Form
Step 2: Purchase Conference & Lodging Packages,
Meals, & Special Options

First Name:
Last Name:
Address:
City, State:
Zip:
Home Phone:
Cell Phone:
Work Phone:
Email Address:
Emergency Contact Person:
Emergency Contact Phone:
Please list first and last names of people in your party, including yourself:
Please list the full names of people purchasing a $20 meal plan (includes free continental breakfast, lunch & dinner on Saturday):
Optional Break-out Session on Saturday: Devotional Tea Time ($10)
Please list the full names of people participating in the tea.
Optional Break-out Session on Saturday: Journaling Craft ($10)
Please list the full names of people participating in the Journaling Craft.
Any special needs your group may have (allergies, handicapped, hearing impaired, etc.):
Indicate which best describes your group?
If you selected "Church Group" or "Other" above, please name your church or specify what kind of group you are in:
Age range of the people in your group (Check all that apply):	14 & under 15-18 19-30 31-45 46-64 65 & up
*We are delighted that you are joining us for Life Empowered's 2012 Conference.* **Remember you are not fully registered until you have paid for your conference & lodging package, optional meal plans, & optional sessions. Submit this form and you will be automatically directed to complete the registration process.

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Contact Us at lifeempowered@hotmail.com or call (641)459-3700 with ?'s.

*Registration ends April 1, 2012. Don't procrastinate or you'll miss an excellent opportunity!
Thank you early registrants for making it possible for us to focus on planning a great conference
instead of spending valuable time recruiting participants.