2018Savannah Presbytery’s Leadership Development Conference

Registration Form

February 16-17, 2018 at Epworth by the Sea

PLEASE read the registration brochure before completing this form.

Each adult attending the conference should complete a separate registration form.

Complete both sides of this form and turn into your church office.For questions, call 912-264-1997.

Clearly PRINT your first and last name as you would like it to appear on your conference badge.

1)CONTACT INFORMATION (important, please fill out completely and legibly):

First and last name (as you would like it to appear on your badge)

______

Mailing Address______

City______State______Zip______

Best Phone Number______

Email Address______

Church______

2)WORKSHOP REGISTRATION

Indicate your first and second choice for each sessionby writing the workshop number in the corresponding space. Choose from the workshop numbers listed in each group.

Workshop1st Choice2nd Choice

Workshop 1A – 8AFri. Evening – 8:00 -9:15 p.m.______

Workshop 8B –14B Saturday Morning – 8:00-9:15 a.m.______

Workshop 15C-21C Saturday Afternoon – 1:15- 2:30 p.m.______

School of the Laity Lunch & Learn – You Must Circle to Attend!Yes I Want To Attend!

(Space is limited, event will happen during lunch on Saturday!)

3) HOUSING INFORMATION:

Roommate (If you are choosing a double, please arrange your own roommate)
(Full Name, they must fill out a separate registration form)______

Special Hotel Needs (Handicapped, etc.)
(please note, there are elevators in all motel buildings)

4) KIDS CAMPREGISTRATION:

Please complete the following information for each child attending between the ages of six months through 5th grade. If you are coming with a second adult, do not duplicate this information on their registration form.

Total No. of Children Attending______

______Child’s Full Name Birthdate Grade

______Child’s Full Name Birthdate Grade

______Child’s Full Name Birthdate Grade

______Name of Parent/ Guardian at Conference Emergency Phone

5)CONFERENCE FEES

Please mark the fees according to the deadline met. Each adult in each room will pay the listed amount. For example, if two people are sharing a double, registering by January 24th, their combined cost will be $210. Call if you have a question. 912-264-1997

Select Your Conference Accommodation / Pay & Register by Jan 24 / Pay & Register between
1/25-1/31 / After Jan 31
May Not Be Available, Call Before Registering / Amount Paid
Commuter Fee / $52.00 / $60.00 / $65
Double Room Rateper adult in room. You MUST specify a roommate on opposite page. / $105/person / $125.00 / $135/person / $
Single Room Rate (one adult) / $150.00 / $170.00 / $180.00 / $
I’d like to stay in Robertson Inn for an additional fee of: / $20/room*** / Not Available / Not Available
Total Fee: / $

*** limited availability – first come, first served by registration date

Thanks for your registration! We look forward to seeing you at Epworth!