Assemblies of God Bible Alliance

Registration Form
Tenth Annual Fire Bible Summit
August 29-September 1, 2011
Whistling Straits - Kohler, WI

YES!

 Please reserve my/our entry to the 2011 Fire Bible Summit at Whistling Straits.
      (Deadline for registration is July 1, 2011)

 We have already provided 400 Fire Bibles ($4,000) in 2011.

 We will give the 400 Fire Bibles ($4,000) by . 
     (Deadline is July 1, 2011. Registration is confirmed upon receipt of funds.)

Make checks payable to Assemblies of God Bible Alliance or Light for the Lost.
All gifts to the Bible Alliance receive LFTL credit. Please send payments to:
1445 N Boonville Ave 
Springfield, MO 65890-0206
Please note this information on checks to Bible Alliance:
4755633 (40)   2010 Fire Bible Summit     SC:AI

Title Rev.Rev. and Mrs.Mr.Mr. and Mrs.Dr.Dr. and Mrs.Ms.Mrs.Miss  Name

I represent (Name of Church, District, Business) 

I am the pastor   I attend the church   Other 

Church/Business Address

City  State  Zip

Phone  E-mail

Home Address

City  State  Zip

Phone  E-mail

Please mail correspondance to:  Church/Business   Home

My spouse is attending  

               is not attending

Other Guests (Please list all persons who will be staying in room.)

Room request   king bed    double bed   
Special Requests 

Reservation Dates: Arriving    Departing

Please enter me in (one event per person):

 Fire Bible Golf Classic
Name

            My partner will be

            Please assign me a partner.

 I plan on participating in the event, but do not wish to golf. 

 I will sign up for a spa appointment (non golfers only). 

 My Spouse, , will be signing up for a spa appointment.