Registration Form March 2, 2013 UICF “It’s Time" Unity Conference” Hosted by V. L. Childs/U.I.C.F. Museum of Aviation GA HWY 247 Warner Robins, GA 10:00a.m. – 4:00 p.m. go to www.vlchilds.com or call Vivian Childs (478) 953-9767 Full Name: _______________________________________________ (First name for badge)____________________________ Organization: ___________________________________________________________________________________ Preferred Mailing Address: __________________________________________________________________________________ City: ________________________________ State/Province: ______________________ Zip/Postal Code: _________________ Telephone: (______)______________ ___________________________ Fax: (______)________________________________ Email: __________________________________________________________________ CONFERENCE FEES 1. Registration Fees (All fees listed in U.S. Funds.) PLEASE CHECK APPROPRIATE REGISTRATION FEE: Individual (lunch included) $35.00 per person $_________ Group (Indicate number of persons in Group) ______ X $35.00 per person $ __________ Group Name__________________________________________________________ will receive 1 additional free paid registration) registration form and indicate it is part of a group. (Groups of ten, when registered together as a group, Please have each individual in your group fill out the 2. Cancellations/Changes and Refunds: Conference fees are non-refundable 3. Payment: TOTAL ENCLOSED: $ __________ First 100 registrations will receive a special conference bag. PAYMENT METHOD: Check or Money Order must be in U.S. funds payable to: VLCHILDS/UICF, LLC. There will be a $25.00 fee charged on checks returned by the bank due to insufficient funds. Please check appropriate box: Check Prepaid cash Credit card processing can be made using the secure PayPal link on the Conference website www.vlchilds.com Please mail completed registration form with payment to: Phone: (478) 953-9767 Email: [email protected] VLCHILDS/UICF, LLC 2006 PO Box 9334 Warner Robins, GA 31095 Do not email credit card information because security cannot be guaranteed. Please use the secure PayPal website for secure credit card processing.
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