Registration Information Form

     Name:_______________________________ Volunteer:_______

       Address:__________________________________

       City:  _________________________      State: ______________

       Postal Zip Code: __________ Phone Number:  (_____) - ______-___________  

                                    E-Mail Address ________________________________

                                                                                                                                                                                       PreRegistration before (early) 02/15/2025  $ 25.00 after 02/15/2025 $ 30.00

                                                            Make Checks to:  Steps To Sobriety 

                                 Mail Checks - Steps To Sobriety 3001 Karen Ave Largo Florida 33774