Registration Form

The Pouring … For Women and Girls

Florence Civic Center
Sunday October 4, 2009
3:00 p.m. – 7:00 p.m.

Free
Pre-event Registration Mandatory

Register Early – Seating is Limited!

Please complete a registration form for each attendee   
Upon completion of the form press the ‘send’ button
Registrations will be confirmed via e-mail

Large groups can register with a single contact name (Must include head count!)

If you experience any technical difficulty, please dial-in your registration(s) at (843) 662-0801.
Pre-Registration Form

The Pouring
* Your name:
* Your email address:
* Confirm email address:
Phone Number:

Your Address:
Church Name or Affiliation:
Head Count if Applicable:
How you heard about
The Pouring:

You must fill in the fields marked with a *