Conference Registration
Recovery in Motion

FULL NAME

EMAIL

Phone Number

Organization

Job Title/Position

ATTENDEE TYPE * Required

Medical Professional

Counselor / Therapist

Recovery Professional

Community Member

Student

Parent / Family Member

Community Resource

Other

Will you be staying for lunch

Yes

No

Comments / Questions?

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contact us

Shoreline Treatment Center
1220 Gregory Street
Taft, TX 78390

Phone: 361-528-3356

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