Kids At Heart Training Services: Register/ Pay Online

Registration Form

Please print and mail this form with payment (or copy and paste it to email and pay online by clicking on the button below) All Registrations received at least 72 hours before the seminar date will have guaranteed seats. All others will be contacted prior to seminar. Walk-ins with no prior registration do not have guaranteed seats.

Kids At Heart

PO Box 21

Lyons, TX 77863

Registration Form

Name of Organization:

___________________________________

Contact Name:

___________________________________

Contact Address:

___________________________________________________________

Contact Number:

(____) _____-_____________

If you wish to receive future information about seminars in your area, please check here

If yes, what is your Fax Number? (____) _____-_____________

Names of Attendees @ $50 each (payment enclosed):

_________________________ _________________________

Names of Attendees @$55 each (will pay at the door):

_________________________ _________________________

(attach extra paper if needed)

The largest group from the same facility wins a special prize!!

Class Date, Location & Time You Wish to Attend:

________________________________________________________

We accept Checks and Money Orders via mail, or Credit/Debit cards online by clicking the button below

Please make checks or money orders payable to Kids At Heart

Payments of $55 will be accepted at the door. (No credit card payments will be accepted at the door).

**Remember! Seats are limited! So register today!**

Enter the information below then press "Pay for your seat now!" to continue with credit card payment (there is a fee of $1.75 per seat to pay by this method)... Be sure to email your registration form or print and mail it to the address above.