MARCH 7-10, 2014 | COLUMBUS, OH | HYATT REGENCY DOWNTOWN

PRIMARY CONTACT INFORMATION:

Church Name First Name Last Name Title Church Mailing Address City State/Province Zip Email Address Church Phone Cell

REGISTER ADDITIONAL ATTENDEES! (Use additional sheet if necessary)

First & Last Name Email Registrant Type & Rate (ie, spouse, $289)

Registration Total $

CONFERENCE PRICING:
Early-Bird
Before October 31, 2013 (rates per person) Alumni Groups of 5+ Groups of 5+ $325 $345 Alumni $345 Individual $365 Spouse $289 College/Sem. Students $299 International $299

Advanced
Before January 15, 2014 (rates per person) Alumni Groups of 5+ Groups of 5+ $345 $365 Alumni $365 Individual $385 Spouse $289 College/Sem. Students $299 International $299

Regular
After January 15, 2014 (rates per person) Alumni Groups of 5+ Groups of 5+ $365 $385 Alumni $385 Individual $399 Spouse $289 College/Sem. Students $299 International $299

PAYMENT INFORMATION
Check - Payable to Group Publishing Check # _________
Visa MC AMEX DISC

Card #:___________________________________________________ Exp. Date: ______/_______ Sec. Code: ___________

Billing:____________________________________________________ Address:__________________________________________________ ________________________________________________________ Print Name on Card ________________________________________________________ Authorized Signature

PRE-CONFERENCE OPTION: Add an extra day of training before SYMC$69 (lunch included)
Enter addition in Additional Attendee Registration Total Below

CALCULATE TOTAL
Primary Attendee Registration Rate Additional Attendee Registration Total Enter discount code amount $_______________ $_______________ - $_______________ $_______________

MAIL THIS FORM AND PAYMENT TO:

Group Publishing/Attn Sherri Smith 1515 Cascade Ave. Loveland, CO 80538

TOTAL AMOUNT DUE

You will receive a confirmation and receipt via email.

For full details and policies, please go to www.youthministry.com/SYMC. Questions? Call Matty @ 615.349.7111