2020 3-Day Academy

Thank you for registering.  

NOTE: a $150 non-refundable deposit is due upon completion of this form and applied to room and board.  Payment in full is due not later than 2/20/2019

*First Name
*Last Name
Address 1
*City
*State
*Zip
*Phone
*Email
Cell Phone:
*Gender
Male
Female
*Age Range
0-18
19-35
36-65
65+
*First time attender:
Yes
No
*Please select one:
Lay
Clergy
Church Staff
*Do you want Continuing Education Credit?
Yes
No
Continuing Education Units

1 1/2 CEU’s are available from the FL Conference (FREE) and/or from the GBOD for a fee of $7.5. A GBOD form will be available for you when you arrive at the Academy.

FL Conference
GBOD $15.00 - payable at check in
*Local Church Affiliation:
Other affiliation if not local church:
*Lodging Options:
First Floor
Second Floor
Handicapped
None
Special Housing Needs:

If you have chosen a First Floor or Handicapped room please list medical need:

*Dietary Needs/Options:
Regular
Diabetic
Vegetarian (no meat)
Gluten Free
List any food allergies:
*Registration choices:

NOTE - DEPOSIT OF $150 IS DUE UPON SUBMISSION OF THIS REGISTRATION AND PAYMENT MUST BE MADE IN FULL NOT LATER THAN 2/20/2020

Single Occupancy ($530)
Double Occupancy ($490)
If you will be selecting Double Occupancy - please list your roommate. Listing your roommate does not register them. They must register separately.
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