Register for the LCMC Annual Gathering

Page 1 of 2

Contact Information

Check One:  LCMC Delegate   LCMC Associate/Member/Visitor   Seminarian

First Name   Last Name

Address   City   State   Zip Code

Phone   Email   Confirm Email

Congregation Information

Congregation Name

Address   City   State   Zip Code

Phone   Email   Confirm Email

Registration Fee

Fee includes lunch Monday & Tuesday and dinner Sunday.Please list any special medical dietary needs for us to consider:

 $75.00: LCMC Congregational Delegates, Associate Members, and Others
 $12.00: Optional Monday Evening Dinner. District Choice
(ie. Cross Alone, Epiphany, ERD, Great Lakes, Heartland, Northwest)
 $50.00: One Day Visitor (specify which date)
 Free: Seminarian

Payment

 Mailing a Check (payable to "LCMC" - your check is your receipt)
 Credit Card (finalize payment on the next screen)