CHRISTEENS REGISTRATION

Please register and pay below for your group or yourself. This registration only grants you access to the conference. It does NOT include lodging. Please ensure that you have reserved sufficient lodging for your group or sign up for our free housing on our housing page.

Group or Individual

Group RegistrationIndividual Registration

Group Name

Contact Name*

First NameLast Name

E-mail*

example@example.com

Phone Number*

Number of students attending

Number of adults attending

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Payments are processed through Square. You may pay using any major credit card / debit card. Or if you wish to pay with check, please see the options below the credit card payment. Checks can be made to Westside Church of Christ • Address: 2300 W. C St., Russellville, AR. 72801

$45 - CT Registration (total number of students and adults)*

$15 - Shirts, size small

$15 - Shirts, size medium

$15 - Shirts, size large

$15 - Shirts, size X-Large

$20 - Shirts, Size XX-Large

$20 - Shirts, Size XXX-Large

Total Amount Due*

Payment Amount

USDDescription

Credit Card

If you wish to mail or bring a check, please check the appropriate box

I will bring my check payment to ChristeensI will mail a check to Westside Church of ChristI will pay with a credit card at the event

CHRISTeens Registration

Credit Card