Early Registration Form
Please use CAPITAL LETTERS
Please print off this form and send it off to the address below.
Please complete in Block Capitals. Thank you.
Title............ First Name ................................... Last Name .....................................................
Address................................................................................................................................
............................................................................................................................................
......................................... Postcode ....................................
Phone No ...............................(Home) ...........................................(work)
Email ......................................................................
I wish to register for the Breath of Life Conference 2007. Please book me lunch on:
26th May ..................... 27th May .....................
Indicate if vegetarian meal required ............................
Cost: £195.00 early bird discount if full payment received by 31st March 2007 or £225.00 if received after this date
Lunch costs £14.50 per day - please note that this needs to be prepaid along with your registration form.
I enclose my cheque for £............... made payable to Breath of Life Conference
I understand that the organisers reserve the right to change the programme due to unforseen circumstances and that no refunds can be made once the booking fee is received
Signed .............................................................. Date .............................................
Please return to:
Rachel Glynn, Conference Administrator
Flat 1, 16A Oaklands Road
Bromley, Kent BR1 3SL
England
Tel: +44-(0)20-8460 2122
email: info@breathoflifeconference.co.uk
* The bursary fund exists to offer subsided places at the conference for those on low incomes or in need of financial assistance