Missouri Mid-South Conference United Church of Christ &

The Christian Church (DOC) of Mid-America

2017 PIM Retreat Registration

The Inn at Grand Glaize

Use the Tab key to move within the form. Please complete this fillable form online, save it, and then email to mms@mmsucc.org by September 11, 2017. Your check may be mailed separately, or you may pay online at www.missourimidsouth.org. If you pay on our website, a completed registration form still must be sent so we know you plan to attend the event.

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Reservations for overnight accommodations are to be made directly with The Inn at Grand Glaize by calling 1-800-348-4731 or www.innatgrandglaize.com. A daily room rate of $89/king bed or $99/2 double beds, not including certain taxes, is available. Please use the group code “MMS17” when making your reservation.

All registrations must be fully paid in advance. Due to resort retreat costs, there will be NO refunds issued after September 11, 2017. Registrations received on 9/12/2017 or after will cost $145.

Please make checks payable to Missouri Mid-South Conference. You may mail this form and your check to : MMSUCC, 483 E. Lockwood Ave., Ste. 15, St. Louis, MO 63119.

Method of Payment: Mail a check ☐	Pay online ☐ Credit Card ☐

2017 PIM Retreat – Includes three (3) meals & all program materials

̴ Cost: $135 per person ̴

̴ Cost 9/12/2017 and after: $145 per person ̴

Dates: Monday, September 18 to Wednesday, September 20, 2017

Location: The Inn at Grand Glaize, 5142 Hwy 54, Osage Beach, MO 65065

Phone: 1-800-348-4731