Healing Meeting & Seminar Online Registration Form

               Name:
               Street Address:
               City:                   State: Zip :
               Email Address:
               Country
               Age (for teens)
               Phone

               Home Church:
               Street Address:
               City:                   State: Zip :
               Email Address:
               Country
             Phone

               I will be attending the Friday Night Healing Meeting Yes or No
               I will be attending the Healing Seminar on Saturday    Yes or No

               We will be offering a box lunch to seminar attendees on Saturday between 12:00 & 1:00.
               Litchfield is often a busy place during lunch hour and we want to promptly continue the
               Seminar meetings at 1:00 PM.

               I will purchase a box lunch at the seminar on Saturday Yes or No
               Boxes will contain a Kentucky Fried Chicken lunch.
               Cost for box lunch is $5.00.
               Money will be collected at registration desk upon your arrival.
               (If you choose the YES option, please understand that we will buy the lunch for you
                With the understanding that you will be their to reimburse us for the cost).

                       CHILD CARE WILL NOT BE PROVIDED.
                       MUST PRE-REGISTER BY SEPTEMBER 30th.

                       You may also call or mail in your registration.
                       Sure Word Ministries Phone: 217-324-3118
                       Address: PO Box 383 - Litchfield, IL 62056





                                                                        Any questions: surewrd@yahoo.com

Thank you so much! I am glad you will be attending!