WV Regional Assembly June 21-23 Registration Question Title * 1. Contact Information Name Home Church Address Address 2 City/Town State/Province ZIP/Postal Code Email Address Phone Number OK Question Title * 2. I am interested in a workshop focusing on: OK Question Title * 3. I will be attending: Friday Evening Opening reception The Saturday Morning Continental Breakfast $7 The Saturday Morning Session The Saturday Men’s Lunch $12 The Saturday Women’s Lunch $12 Saturday evening dinner/picnic $15/adult Saturday evening dinner/picnic $8/under 12 Sunday Morning Continental Breakfast $7 Sunday Morning Worship OK Question Title * 4. I have the following food allergies: OK Question Title * 5. I plan to Pay: At the Event By sending a check/cash to the Regional Office I have made prior arrangements with the Regional Office Please email me with the Regional Square Account to pay by creditcard OK Question Title * 6. I would like to register the following people attending with me: Name 1 Name 2 Name 3 Name 4 Name 5 Name 6 OK DONE