Only One Form per Person. Please check the appropriate box. Then complete all of the fields below with your information. Thank you.
Birthdate: MONTH/DATE
Your Age:
CHILD/YOUTH 5-17yrs
 ADULT/18yrs+
Last Name:
First Name:
Contact Phone:
Mailing Address:
City/State/Zip
Today's Date: MM/DD/YYYY
T-Shirt Size:
E-mail Address:
A.   REGISTRATION AND PAYMENT: Please complete Sections (1) and (2) below.
(1) REGISTRATION: Please Select           
LATE: 11/1/15 to 12/30/15
$95/ADULT ages 18yrs+
$75/YOUTH ages 11-17yrs
$50/CHILD ages 5-10yrs
(2) PAYMENT OPTION: Please select below. [Note: ALL REGISTRATION PAYMENTS ARE NON-REFUNDABLE
and NON TRANSFERABLE. No Exceptions.]
PAYPAL: Within 1 hour  we will send you a personal Paypal link to the email address you gave above. You will then have until
11:59pmCT on Wednesday, December 30, 2015 to click on that link and make your payment. Payment must be paid/received before
the 11:59pmCT deadline on Wednesday, December 30, 2015. No Exceptions.
B.  HOTEL & LODGING
COUNTRY INN & SUITES, 1837 Centre Point Circle, Naperville IL 60563
HOTEL: $81/night + tax (Must be registered in order to get Room Rate)
Room Types: King Suite, Standard King, Standard King/Queen Combo, or Double Queen
All reservations must be guaranteed by one night’s deposit or a Major Credit Card
To Book: Call the Hotel @ 630-505-3353  or toll free 1-800-596-2375 [Mention Code: HUGG Group]
Conference Room Rate available 2 days before & 2 days after Conference dates.
2016 H.U.G.G. ONLINE REGISTRATION FORM
"She A'Rose"
January 22-24, 2016
Naperville IL., January 22-24, 2016. Registration is open until all Rooms Sell out. ALL REGISTRATION PAYMENTS ARE NON-REFUNDABLE and   
NON- TRANSFERABLE. No Exceptions. Please use only one form per person. Once you complete this form, we recommend that you download and
print a copy of it to keep for your records. We are so excited that you're coming!
HIM
c/o HUGG 2016
PO Box 653
Lansing IL 60438-0653


Email:
HUGG@kingdombread.com