Online Registration Form

Teen Life Conference - Aug 1-3, 2008

Cost $75.00
Ages 13-17

Please fill out the appropriate blanks and hit the Submit button at the bottom of the form.

Name:
Age
Street Address:
City:
State:
Zip:
Phone:
Email:
Home Church:

Please send your deposit of $20 by July 20, 2008 to Mr. Brad Winsted, 3926 Thornridge Way, Atlanta, GA 30340.

Make your check out to "MRCC" and indicate "Teen Life Conference"

Thank you and the Lord bless

Conference Organizer Mr Brad Winsted.