REGISTRATION:  
2018 Diocese of St. Augustine Catholic Charismatic Conference
January 26-28, 2018

NAME ___________________________________PHONE ____________________________
E-MAIL________________________ADDRESS____________________________________
CITY__________________________ST______________________ZIP__________________

Pre-registration must be received by January 20, 2018   
NUMBER ATTENDING ______ X FEE ($25) Per Person = TOTAL  $_________
Tax deductible donation to make it possible for someone less fortunate to attend + ______
TOTAL ENCLOSED $ __________

Make Payment to CCC and mail to:
M. Cavallo, 7543 Cliff Cottage Court, Jacksonville 32244

At the door, registration will be $30. Priests, Seminarians, Religious, and Youth age 18 and younger -
NO FEE but PLEASE REGISTER. Nobody will be turned away. . . If you cannot afford registration
please come anyway.