All questions marked by an asterisk are required

Event Name: Senior Living Celebration 2019 - Madisonville
  {xxx-xxx-xxxx}

 
 

You will be charged:

$20.00 per person if registering by April 3

 

$25 per person after April 3 or at the door

 

 

 

 

    ($20.00 Each)
*Are you a Senior Adult leader in your church or association?
 Yes 
 No 

*Method of Payment: Check Credit Card

If you select check your registration will not be complete until the check is received at the following.

Kentucky Baptist Convention

Attn: Mary Livingston

13420 Eastpoint Centre Drive

Louisville, KY 40223

  {Checking this option will save your information for future registrations}