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 Name

Contact Name

First NameLast Name

E-mail

example@example.com

Phone Number

Format: (000) 000-0000.

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

CHRISTeens Registration

Payment Amount

Credit Card