2018 Choosing to Care Conference Registration

PLEASE NOTE:

CHILDCARE:
Childcare is limited, so please register early. Please note that we can only accept childcare registrations for children 3 months through 5th grade.

LUNCH:
We will have Chick-fil-A sandwiches and nugget meals available. There is a suggested payment of $5 per person and $20 for 4 or more people. Please click on the following link to pay for lunches. It will open up in a new window. Please specify your payment amount, how many Nugget Meals vs. Sandwich Meals, complete the Paypal payment, and close the window. Your Registration form will still be right where you left off. Thank You.

https://www.paypal.com/cgi-bin/webscr?cmd=_s-xclick&hosted_button_id=WQ9M2TFVFYHTC

First Name *
Your answer
Last Name *
Your answer
Spouse's First Name (if applicable)
Your answer
Spouse's Last Name (if applicable)
Your answer
Is your spouse also attending the conference?
By sharing your spouse's name and checking "Yes" below, you are automatically registering your spouse for the conference as well. There is no need to complete the registration form again for your spouse as long as we have his/her name and this question is answered.
Street Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Email *
Your answer
Phone *
Your answer
Will you need a Certificate of Continuing Education to document your credit hours gained from attending this conference? *
Required
Would you like to purchase Meals?
We will have Chick-fil-A sandwiches and nugget meals available. $5 per person and $20 for 4 or more people. Please click the link at the top of the page. It will open up in a new window. Please complete the Paypal payment and close the window. Your Registration form will still be right where you left off. Thank You
How Many Adult Chick-fil-A Sandwich meals do you wish to purchase?
We will have Chick-fil-A sandwiches and nugget meals available. $5 per person and $20 for 4 or more people. Please click the link at the top of the page. It will open up in a new window. Please complete the Paypal payment and close the window. Your Registration form will still be right where you left off. Thank You
How Many Kid's Chick-fil-A Sandwich meals do you wish to purchase?
We will have Chick-fil-A sandwiches and nugget meals available. $5 per person and $20 for 4 or more people. It will open up in a new window. Please complete the Paypal payment and close the window. Your Registration form will still be right where you left off. Thank You
How Many Adult Chick-fil-A Nugget meals do you wish to purchase?
We will have Chick-fil-A sandwiches and nugget meals available. $5 per person and $20 for 4 or more people. Please click the link at the top of the page. It will open up in a new window. Please complete the Paypal payment and close the window. Your Registration form will still be right where you left off. Thank You
How Many Kids Chick-fil-A Nugget meals do you wish to purchase?
We will have Chick-fil-A sandwiches and nugget meals available. $5 per person and $20 for 4 or more people. Please click the link at the top of the page. It will open up in a new window. Please complete the Paypal payment and close the window. Your Registration form will still be right where you left off. Thank You
Do you want to Register any Children?
Please note: Our childcare is full below second grade. If you have a child second grade through fifth grade that you need to register, please email Stephanie Mann at smann@chosenforlifeministries.org.
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