Registration Form 

THE EDGE RETREAT

May 16, 17, 18, 2008 

    $175.00 Bunk or $225.00 Private

Includes board, meals and classes

                             ( * Required Field )      Visa or Mastercard Onlyl

	* Name       * Address * City * State * Zip Phone * Email                            Credit Card Information * Name as it appears on card        * Credit Card Number Visa,  Mastercard    * Expiration Date Month/Year 01 02 03 04 05 06 07 08 09 10 11 12      08 09 10 11 12 13 *Date, No. of Tickets & Amount
	sueborg@xmission.com It's a Miracle Center  1292 East 4085 South Salt Lake City, Utah 84124