A Christian Clown Retreat - TOCCOA, GEORGIA


DON’T DELAY….REGISTER TODAY! THREE ways to register:  1. Complete the form below and mail it to:  Angela Gonzalez, 116 S. Audubon Road, Apt. 4, Indianapolis, IN 46219.  Include check or credit card information.  (One form must accompany EACH person registering.) 2. Fax the completed form with credit card information to 1-317-327-4230; ATTN:  Angela Gonzalez. 3. Visit the website at and register using PayPal.  NAME__________________________________________________________ I am claiming a GROUP Discount, and the names of   those registering with me are as follows: CLOWN NAME__________________________________________________ _____________________________________________   _____________________________________________ ADDRESS______________________________________________________   _____________________________________________ CITY/STATE/ZIP________________________________________________ _____________________________________________   E-MAIL ADDRESS______________________________________________   PHONE NUMBER_______________________________________________   PAYMENT:  Check made out to:  TNT University Clown Camp 
Visa Master Card       Name on Card_________________________________________________  Card Number__________________________________________________  Expiration Date________________________________________________  CVC (3 digit code on back of card)_____________________________   Automatically charge credit card monthly for payment plan. Y N  ADDRESS (where you receive your credit card bill, include zip code)

________________________________________________________________ ________________________________________________________________   Signature of Card Holder____________________________________________________
  REFUND POLICY:  Any cancellations made before April 1 will receive a full refund less $50.  After April 2, but before June 27, refunds will be made less the amount equal to 1/2 of your total registration.  No refunds of any amount will be made after June 27.