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Registration Form<br />
(Register ONLINE at www.freshwind.ca)<br />
Last Name First Name Age<br />
Address<br />
City/Town Province Postal Code<br />
Phone Email Address<br />
Church<br />
Denomination<br />
enclosed Fee<br />
Registration gives you access to all general sessions, workshop sessions, Saturday lunch and Sunday brunch.<br />
$90 18-25 yrs old $10518-25 yrs old $125 26 yrs and over $140 26 yrs and over<br />
earlybird Regular earlybird Regular<br />
*received on or before *received on or before *received on or before *received on or before<br />
September 24, 2010 October 8, 2010 September 24, 2010 October 8, 2010<br />
$12018-25 yrs old $150 26 yrs and over<br />
ON SITe ON SITe<br />
(if space is available) (if space is available)<br />
Method of Payment<br />
Cheque<br />
(Payable to freshwind)<br />
Credit Card<br />
Account Number Expiry Date<br />
Cardholder’s Signature<br />
NOTE: Credit charges will appear on statement as “PAOC-AB & NWT”<br />
October 22-24, 2010 in Red Deer at CrossRoads Church • www.freshwind.ca
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