Registration Form

Course and Conference Application Request Form

Please circle one:

Mr/Mrs/Ms/Pastor/Rev/Dr

Male

Female

Age Group:

18-30

Name:

31-50

51+

Address:

City:

Province/State:

Postal/Zip Code:

Home Phone:

Work Phone:

E-mail:

Fax:

Please list your course or conference selection/s:

Payment Enclosed

deposit only*

fees in full

I require Bed & Breakfast

I require the meal package

Payment Enclosed

deposit only*

fees in full

I require Bed & Breakfast

I require the meal package

Payment Enclosed

deposit only*

fees in full

I require Bed & Breakfast

I require the meal package

Please deduct $________________ from my VISA/MasterCard account

Account Number

Expiry Date

Name as it appears on card (Please print)

Please find a cheque enclosed for $__________________ to cover the above course/s I am attending.

I would like to donate $_________________ towards the cost of a course for someone who is experiencing financial difficulties and would otherwise be unable to attend.

*A non-refundable, non-transferable $50 deposit is required to secure your booking.
This can be made either by cheque payable to Singing Waters Ministries, VISA or MasterCard.

Please indicate to us if you have any special needs that we need to be aware of to make your visit with us more comfortable e.g., dietary, allergies or disabilities), as preparation needs to be made in advance of your arrival: