To register for this “Reconciliation Weekend,” simply complete this form and return it to:

Jama Edlund
“If Not For Grace Ministries”
PO Box 836 Grain Valley, MO 64029

Reconciliation Weekend includes two night stay at the Mansion, five meals, and retreat materials. (Cancellation fee: $100)

Deadline for final payment to attend is February 17, 2012
There will be no refunds after this date. Scholarship applications are available to apply.

Transportation will not be provided. If you would like to commute with other participants or if you have any special needs, please call us at 816-847-2911.

Name _____________________________________________

Spouse’s Name _____________________________________

Address ___________________________________________

City __________________________ State ____ Zip ________

Daytime Phone _____________________________________

Evening Phone _____________________________________

E-mail Address _____________________________________

Single Early Bird Discount (Pd in full by 1/27/12) ............... $229
Couple Early Bird Discount (Pd in full by 1/27/12) .............. $259
Standard Single Rate (Pd after 1/27/12) ............................. $259
Standard Couple Rate (Pd after 1/27/12) ............................ $289

Please make checks payable to INFG.