One person per form please. Registration Includes Lunch.

Name:____________________________________

Address:__________________________________

_________________________________________

Phone #:________________________________

E-mail:__________________________________

Check type of registration:

___Individual registration -   $45 ($55 at door)

___Register with a Friend and Each Receive a $5 Discount (must mail all registrations together)

Lunch Options

___ Regular Lunch     ___ Vegetarian Lunch

___ Child Care $6 for each child (includes lunch.)        Number of children ______

TOTAL ENCLOSED: _______________

Mail this form along with check or money order made out to Shine Ministries to:

Shine Ministries

1719 S Euclid Ave

Princeton, IL 61356

When your registration is received a confirmation ticket will be mailed to you.

Scholarships are available upon request.  Email shinewomensministry@yahoo.com