Register for the Conference On Line - Presbyterian Men in the Synod of the Mid-Atlantic

This page is to be used for on-line registration for the 2012 Men's Conference
Before completing the page, please read all the directions fully.

This is a 2-step process.

Step 1 - Complete the form below. All fields marked (*) must be completed or you will not be able to submit the form for processing. When you have finished, click on "submit." This will submit your information to the database and you will be transferred to another page thank you for your registration and giving you instruction on how to pay. In addition, you will automatically receive an email summarizing your registration information.

Step 2 - If you wish to pay be credit card, please click on the "Credit Card Only" button and you will be transferred to PayPal to complete the credit card transaction. If you wish to pay by check, follow the directions for sending checks.

Presbyterian Men's Conference 2012 Registration:

Last Name:

First Name:

Nick Name:

Street Address:

City:

State:

Zip:

Church:

Presbytery:

10.

Daytime Phone:

11.

Evening Telephone

12.

Email Address:

13.

Emergency Contact Name:

14.

Relationship and Telephone #:

15.

Roommate Requested:

16.

Special Needs:

17.

Times attending Conference (Prior to this year):

18.

Attending with my Dad/Son - Name

To complete the registration form, you must select a registration package from the options below. You may also select a special activity in which you would like to participate. All costs are shown.

Package A - Deluxe package - $308. Includes conference registration, 6 meals, room for 2 nights in the New Lodge (Double occupancy)(2 Queen beds, private bath)

Package B - Deluxe Single Occupancy - $370

Package C - Regular Package - $265. Includes conference registration, 6 meals, room for 2 nights in Richardson Building (Double occupancy) (Single beds, shared bath with adjacent room).

Package D - Regular Single Occupancy - $315

Package E - Each One Bring One Rate (explained below)

Package F - Day Package - $162. Includes 6 meals, but no lodging.

Package G - Conference Only - $85. No meals, no lodging.

(Each One Bring One Rate: A registrant who brings a first time conferee will receive a $50 discount on BOTH registrations based on a double occupancy providing they room together. (Lodge: $258 each; Richardons: $215 each)

19.

Select one of the packages below

	Package A - $308			Package B -$370			Package C - $265			Package D - $315
	Package E - See Discount			Package F - $162			Package G - $85

20.

Special activities for Saturday afternoon. Select desired activity. If you wish no activity, please select that button.

	Golf Tournament - add $45			Bus Tour of Area - Add $12			Appalachian Trail Hike - no cost
	No activity

21.

Please Total cost of items checked. Type that cost in the box and click "submit" to submit the form.

* Enter Your Email Address:

Type in the text that you see above: