Registration

2013 REGISTRATION FORM

Host Minister: Leo G. Gay

North Las Vegas Church of Christ
2626 N. Martin L. King Blvd
North Las Vegas, Nevada 89032
Phone: 702-648-8283
Fax: 702-463-0229
Email: coconmlk@earthlink.net
Website: www.northlasvegaschurchofchrist.com

Coordinator: Taryn Jackson

Register and make check(s) payable to:
National Christian Singles Seminar
Attn: Registration Committee
P.O. Box 372064
St. Louis, MO 63137

For mail in registration form, click .pdf below.

2013_registration_form.pdf
File Size:	260 kb
File Type:	pdf

Download File

Online Registration *

Regular ($160) Due by July 31, 2013

Payment Information:

Payments methods by check, cashier check, money order, or Pay Pal (with applicable fees). No personnel checks accepted. Please note fees are non-refundable after June 30, 2013. All fees incurred to NCSS due to insufficient funds are the responsibility of the registrant and must be paid prior to check in. Lastly, late registrants are not guaranteed registration packet incentives, to include t-shirt and souvenir booklet. We encourage early registration!

Identity Theft Warning:
It is very important not to give personal information via the NCSS website
unless for purchase only. Otherwise, it will be discarded and NCSS will not be
held liable for any damages.

Name (One registration per applicant) *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Contact Number *

Congregation/Church Name *

Emergency Contact Name *

First

Last

Emergency Contact Number *

Relationship *

Tee Shirt Size *

List any medical issues or food allergies *

Name of Attendee *

Name of Card Holder *

Submit

(After you have completed the registration form, please click DONATE to make your payment via Paypal.)