“Breakthrough” Ministry

Regional Intercessory Prayer & Prophetic Conference

(Prayer Breakfast)

Registration Form

Name  ________________________________________                                           Adults - $30.00    

Address ________________________________________                  Children 12 and under - $10.00

             ________________________________________                  Registration Fee Non-Refundable                         

City ____________________ State ________ Zip ______                   Registration Deadline is 8-12-15

Home #________________________                                                       Child Care Provision - Limited

Cell   # ________________________                                                       Mail Registration to: B.O.L.T.

                                                                                                                           1133 10^th St. N.E.

Home Church ____________________________________                  Massillon, Ohio  44646

       Make Check or Money Order Payable to Breath of Life Tabernacle                                 

               (* In Memo: For Prayer Conference or “Breakthrough”)                                     Amt. Paid $_________Ck. /MO

                                                                                                                                                                   #___________________

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We are asking 100 Believers to join us for 1 hour of Prayer on Saturday, August 22^nd @ 8:30 am Registration starts at 8:00 am & Breakfast after Prayer. Be sure to bring your Prayer Shawl (Tallit)!