2026 Conference: Print Registration
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Pre-Registration: $40.
ONE FORM PER REGISTRANT
Optional Lunch ($10) and Dinner ($18) add-ons available. Please complete by July 16, 2026
Please fill in ALL FIELDS and CHOOSE LUNCH/DINNER options
Last Name
First Name
Email
Full Address
Phone
Special Needs
Lunch Choice:
(pick one for $10)
Honey Baked Ham Lunch includes Chips & Chocolate Chip Cookie (except GF option)
Turkey on Baker’s Roll, Lettuce, Tomato, Cheese, Honey Mustard and Mayo on the side
Ham on Croissant, Lettuce, Tomato, Cheese, Honey Mustard and Mayo on the side
Chicken Salad on Croissant, Lettuce, Tomato, Cheese, Mayo on the side
Vegetarian on Ciabatti, Lettuce, Tomato, Cheese, Ranch on the side
Gluten-Free Chef’s Salad , with Ham, Turkey and Cheese, Dressing on the side
NO, Lunch
Dinner Option:
(for $18)
YES, I would Like Talerico’s Dinner Option
INCLUDES:
City Chicken (breaded pork w/light gravy) and GF Grilled Garlic Parm Chicken (with garlic butter and fresh parsley)
Sides: Loaded Mashed Potatoes, GF Vegetable Medley
Salads: Broccoli Salad, GF House Salad
NO, Dinner
Total
Make check or money order to: CDCR (Catholic Diocese Charismatic Renewal)
Mail to: Sandy Pawlak, 6665 Pitts Blvd., N. Ridgeville, OH 44039
Information: 440 944-9445
1st CRM Conference?
YES
NO
Youth (under 18) Registration FREE. No group or senior discounts are available.
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