registration form only.

April 24-­‐25 FINAL&REGISTRATION&DEADLINE&IS&APRIL&15th&
Chautauqua Camp & Conference Center Miamisburg, OH Registra;on Closes April 15 2015
A"completed"registration"form"is"required"for"each"person."""
You"may"register"online"at"EscapeToRenewal.com""
or"mail"this"form,"with"payment,"to"the"address"below."
"
Name:"_____________________________________" " Your"eMail:""_________________________________"
Address:"___________________________________" " Your"Church"Name:"__________________________"
City,"State,"Zip:"_____________________________" " Church"eMail:"_______________________________"
Phone:"(______)_____________________________" " "
REGISTRATION&&&PAYMENT&
&
Registration"&
☐&$75"(No"Lodging"Included)"
☐&$90"(With"OnQCampus"Lodging)"
&
FREE&Pastors’&Wife/Missionary&
☐!Free"registration""
☐!Free"onQcampus"lodging""
The!cost!of!off*campus!lodging!is!
NOT!included.!
!
Single&Day&Registration
☐&$50/Friday"""or"""☐&$50/Saturday"
Featuring two keynote speakers. . . Shelley Hendrix Church4Chicks Atlanta, GA " PREHREGISTRATION&IS&REQUIRED&
Registrations"submitted"online"or"postmarked"after"
April"15"will"NOT"be"accepted."You"may"NOT"
register"at"the"door."
"
CANCELLATION&POLICY&&
Refunds"(less"$20"processing"fee)"will"be"made"for"
cancellation"up"to"and"include"the"day"before"the"
event."Registration"fees"are"transferable."To"request"
a"transfer"of"your"paid"registration,"please"call"937H
746H3811.&
!
A"completed"registration"form"is"needed"for"
EACH"PERSON."Make"your"check"payable"to"
Camp"Chautauqua.""
"
Mail&form&and&payment&to: &
Kristan Dooley Author, Speaker CincinnaC, OH For more informaCon, visit www.EscapeToRenewal.com. • All"onQcampus"accommodations"are"heated."
Bring"your"own"bedding/towels,"etc."
• Please"respect"others"and"return"to"the"
dormitories"only"when"ready"to"retire"quietly"for"
the"night."For"“late"night”"activities,"other"
common"areas"will"remain"open.""
RENEWAL& &
P.O.Box&439 &
Milford,&Ohio&45150 ! !
!!
Plus the shopping expo, breakout classes, craF class, table-­‐talks, prize baskets, fun acCviCes, great music, delicious food and more! Don’t miss it! "
ONHCAMPUS&LODGING&IS&LIMITED&TO&300&
• Lodging"is"assigned"in"the"order"that"all"
registrations"are"received."Newer"dormitories"fill"
quickly,"so"please"get"your"registrations"in"early.&
Every&effort&will&be&made&to&keep&churches&
together,&but&cannot&be&guaranteed.&
You!will!receive!confirmation!of!your!
registration.&
!
• No"infants"or"children"please."
"
"
See you soon!
Visit"www.EscapeToRenewal.com"
"
for"details"or"to"register"online"
"
For"more"information,"please"call"937Q746Q3811&&
or&contact"Pat"Beckman,"Director"of"Registration"at"[email protected]"