Only One Form per Person. Please check the appropriate box. Then complete all of the fields below with your information. Thank you.
Your Age:
CHILD/YOUTH 5-18yrs
ADULT/19yrs+
Birthdate: MONTH & DAY
First Name:
Last Name:
Contact Phone:
City/State/Zip
Mailing Address:
E-mail Address:
Today's Date: MM/DD/YYYY
I WOULD LIKE TO ORDER A HUGG T-SHIRT
REGISTRATION AND PAYMENT: Please complete Sections (A) and (B) below.
(A) REGISTRATION: Please Select. DEADLINE IS FRIDAY, JANUARY 17, 2020
$50/YOUTH ages 10-18yrs; SENIORS ages 60yrs+
$30/CHILD ages 5-9yrs
$65/ADULT ages 19-59yrs+
DAY PASS FOR SATURDAY SESSION ONLY: JANUARY 25, 2020, 9AM-3PM
$75/PERSON  (MUST BE PAID BEFORE JANUARY 22, 2020)
(B) PAYMENT OPTIONS: Please read carefully and Select the Box below how you will pay.
[Note: ALL REGISTRATION PAYMENTS ARE NON-REFUNDABLE and NON TRANSFERABLE. No Exceptions.]
ENTER TOTAL AMOUNT DUE:
Quick Pay via CHASE Zelle send to: Jesus@kingdombread.com    

Cash App: $kick316
     Note: FULL PAYMENT MUST BE SUBMITTED WITH THIS COMPLETED REGISTRATION FORM            
HOTEL & LODGING
After you pay your Registration, please call the Hotel and book your room.
Last Day to Book at Conference Rate is January 17, 2020. After this date, rooms and rate are not guaranteed.
Country Inn & Suites, 8311 Ohio Street, Merrillville, IN 46410
Standard Double Rooms available @ special conference room rate of $79 + 12% tax/night. To Book you must call the    
Hotel @ 219-736-1300 and
Mention Code: Kingdombread HUGG Group. Major Credit card needed in order to book.
You must be completely registered with HUGG in order to get special conference room rate.
ONLINE REGISTRATION FORM
2020 H.U.G.G. WORD ADVANCE GETAWAY FOR MEN & WOMEN
"20/20 PROPHETIC VISION"
January 24-26, 2020
Country Inns & Suites, Merrillville IN
Dear Friend, please use this form to REGISTER for our 2020 HUGG Word Advance Getaway for Men & Women, being held at the Country Inns &
Suites, Merrillville, IN, January 24-26, 2020.
 ALL REGISTRATION PAYMENTS ARE NON-REFUNDABLE and NON- TRANSFERABLE. No Exceptions.
Please use only
one form per person. Once you complete this form, we recommend that you download a copy to keep for your files.
PO Box 653
Lansing IL 60438-0653

Email:
HUGG@kingdombread.com

Phone:
833.273.2348