Kentucky Church of God of Prophecy

KY Ladies Retreat Registration

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Give me Jesus

Name


First Name	Last Name

Address


Address

Address Line 2

City	State	Zip Code

Email Address

Phone

Phone Number

Church you attend

Please check all that apply

Select all that apply

Staying at Camp Nikao (Lodging/Meals/Snacks) $105.00 *
Staying in a Motel/Home (Meals/Snacks) $ 65.00
Services Only $ 55.00
Yes, I will be participating in the Art class. (Payment of $7 due at the event)
Yes, I will be participating in the Scrapbooking class. (Payment of $7 due at the event)

* $5.00 Discount if paid before April 15, 2017 use coupon code EARLYBIRD when paying online

Payment Preference

Select one

Pay by Bank Checking Account ($.50 transaction fee for any tuition amount you choose)
Pay at the Door
Pay online below

$105.00 Tuition fee + $3.25 transaction fee

Cost: $108.25 each
Select Quantity

$ 65.00 Tuition fee + $2.25 transaction fee

Cost: $67.25 each
Select Quantity

$ 55.00 Tuition fee + $1.75 transaction fee

Cost: $56.75 each
Select Quantity

* required