Care Conference Online Registration Form

Care Conference Online Registration

Please fill in the form below. You can register up to two guests at a time. Payment $60 per person (or $50 early bird before Mar 1) can be sent to Westview Baptist Church by cheque or e-transfer to careconference@westviewbaptist.ca (please note your name(s) in the memo to help us know who the payment is for)
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
E-mail*
example@example.com
Phone Number*
First Person's Breakout Options

Please fill out options for person named at the top of this registration form
Breakout #1 Selection (11am - 12 pm): Choose two options if your first choice has a limited size group*

Painting With Pastor Tina (Limit of 15 participants - Must sign up for part 1 and 2)Help! I Have Teenagers - Sheila Reid RSW (10 Participants)Calm Your Mind With Food - Charlene Cunningham MSWSetting Healthy Boundaries and Saying No - Rev Leanne FriesenLyndon's Fog: A Journey Through Alzheimer's - Carolyn Bagnall
Breakout #2 Selection (1:30pm - 2:30 pm): Choose two options if your first choice has a limited size group*

Painting With Pastor Tina (Limit of 15 participants - Must sign up for part 1 and 2)Feel the Fear and Do It Anyway - Charlene Cunningham MSWHow to Avoid Burnout as You Care for Others - Rev Cid LattyThe Power of Praise- Carolyn BagnallSelf Care and Mission - Erika Abele MDiv, MSW, RSW
Second Person's Breakout Options
Name

First NameLast Name
Breakout #1 Selection (11am - 12 pm): Choose two options if your first choice has a limited size group

Painting With Pastor Tina (Limit of 15 participants - Must sign up for part 1 and 2)Help! I Have Teenagers - Sheila Reid RSW (10 Participants)Calm Your Mind With Food - Charlene Cunningham MSWSetting Healthy Boundaries and Saying No - Rev Leanne FriesenLyndon's Fog: A Journey Through Alzheimer's - Carolyn Bagnall
Breakout #2 Selection (1:30pm - 2:30 pm): Choose two options if your first choice has a limited size group

Painting With Pastor Tina (Limit of 15 participants - Must sign up for part 1 and 2)Feel the Fear and Do It Anyway - Charlene Cunningham MSWHow to Avoid Burnout as You Care for Others - Rev Cid LattyThe Power of Praise- Carolyn BagnallSelf Care and Mission - Erika Abele MDiv, MSW, RSW
Lunch is included. Do you (or the second registrant) have any dietary restrictions?*
Ticket Options:*

$60 (Regular Registration on or After March 2nd)$120 (Two Regular Registrations on or After March 2nd)
Payment Options*

I will send an etransfer for the above amount to careconference@westviewbaptist.caI will send a cheque to Westview Baptist Church at 1000 Wonderland Rd S., London ON, N6K 3S4I will drop off payment in person to Westview Baptist ChurchI have made another arrangement with Westview Baptist Church
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Care Conference Online Registration

First Person's Breakout Options

Second Person's Breakout Options