CSM - Charles Simpson Ministries
CSM Leadership Conference 2012
May 16th–18th | Gatlinburg, TN


This online registration is for general registrants only. If you are a member of the team or if you have special arrangements please contact us by phone at 1-888-811-2276 or email betty@csmpublishing.org. This registration includes registration fees, meals and hotel stay.

Your Information:
Full Name:*  
Spouse (If Attending):
Address:*
City:*
State:*
Zip Code:*
Phone Number:*
Fax Number:
Email:*
General Registration:
How many people are you registering today?* 

What type of room would you like?**

Double Occupancy ($300/person) Single Occupancy ($390/person)

Roomate List:** (please separate with a comma)



How many people in your party will be participating in the 18 Hole Golf Tournament on Thursday, May 17th?* ($40/person)

Please list each golfer's score:


This year's golf fees must be pre-paid with registration. NO GOLF REFUNDS AFTER APRIL 23rd.

Payment Options:

Note: We cannot guarantee rooms without payment. We offer two payment options:

Option #1: Payment Plan
I am interested in a payment plan. Please have someone contact me. I understand payments will start Feb 1st and will last until April 2nd and that payments can be made by check, money order or credit card.


Option #2: Pay with Credit Card
*Please note: This section is not required if Option #1 is selected. Skip to total.

Card Type*
Mastercard
Visa
American Express
Name on Card*
Address on card:*
City/State:*
Card Number:*
Exp Date:*
(MM/YY)
Total:
$
Update Total
* Enter the characters shown on the right:

TERMS:
* Fields marked with * are required.
**A $15 late fee will be applied after April 2, 2012. Please note that regular registration prices may be different if you choose to have more than two people to a room. Please call (888)811-2276 for details. Please make your own arrangements for roommates.
CANCELLATION POLICY: All cancellations are subject to a $25 cancellation fee. No refunds after April 4, 2012.