CPC 39th Annual Spring Benefit Registration

39th Annual CPC Women’s Health Resource Benefit

Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone
Email*
Church (if applicable)
Adults in Party Quantity*
Price: $10.00
Youth in Party Quantity
Price: $0.00
Total
$0.00
Please don't let the registration fee stop you from coming. If the fee is a barrier to your attendance, check the box below, and we will waive the cost.
- Please waive my registration fee.
Additional Information

List additional guest names here as well as any other information we need to know.
Credit Card

Please consider mailing a check to help us to avoid processing fees. Write “Benefit Tickets” in the memo line. CPC Women’s Health Resource, Attn: Jonie, 1410 W. High St, Bryan, OH 43506