Pre-Registration closes July 29th.  Onsite Registration only after July 29th.  You can print this page and then mail or fax the completed form or e-mail Cecilia Siel at info@visionquestcenter.com.

Vision Quest Educational Center and Bookstore
3602 Colby Ave
Everett, WA 98201
 Phone: (425) 252-1591
Fax:  (425) 339-8264
Best hours to call are from 10 am -7 pm

Pre-registering - Please pay the full amount or $65 deposit for each registration. The remainder will be due at the door.
On-Site - Full amount due at the door.
Children - This year's program for children will run concurrently with the adult  program.  Please register as early as possible.

Adult________________________________________ Adult________________________________________
Child's name & age_____________________________ Child's name & age_____________________________
Child's name & age_____________________________ Child's name & age_____________________________
Address___________________________________________________________________________________
City/State/Zip______________________________________________________________________________
Phone (Day)________________________ (Eve.)____________________________
E-Mail:_______________________________________
Church Affiliation/City_____________________________________________________________

T-shirts will be fashioned after the event logo art. SM, MED, LG, and X-LG are $15 each; XX-LG and XXX-LG are $18. Prepayment is required.  For further questions please contact the Registrar.

Payment Schedule
____ Adults @ $165 ______
____ I am enclosing full payment

____ I am paying by ____Check ____Money Order ____Cash

____ Please charge my VISA/MC #_____________________________

Exp. date_____________________________

Authorized signature_________________________________________

   Today's Date________________________

____ Children @$65 ______
____ Children @ $40 ______
____ T-shirts @ $15* ______
____ T-shirts @$18* ______
Total Amount Due ______
Balance (due on site) ______

*T-shirts (mark quantity by sizes)* ____SM  ____MED  ____LG  ____X-LG @$15        ____XX-LG ____XXX-LG @$18.  T-shirts must be prepaid.