This information will be used in the event of an emergency during the time you are at Assembly.
Please use a separate form for each person, including visitors. Thank you.
Paying by check? Mail check to:
Region One Assembly Registration
P. O. Box 23235
Tigard, OR 97281 United States
Please write your name and "Assembly Registration" in the memo of the check. Your registration is incomplete until payment is received. Thank you.