Cornerstone Church

IMPACT WEEK REGISTRATION FORM

Name1:

Name2:

Name3:

Name4:

Name5:

If there are more than 5 attending, please e-mail the rest of the names.

Church:

Address:

City/State/Zip:

Phone Number:

E-mail Address:

#1 - Worship Seminar with Russell Fragar - Monday, May 19th @ 6:00PM

X $30 per person

X $25 per person from the same church (5 or more paying together)

X $22 per person from the same church (15 or more paying together)

X $15 per full time student

#2 - Pastor & Church Leadership Seminar - Tuesday, May 20th @ 7:00 PM

X $39 per person

X $33 per person from the same church (5 or more paying together)

#3 - Church on Fire - Community Impact Service - Wed., May 21st @ 7:00PM

FREE ADMISSION!

- TOTAL DUE