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Youth Ministry Registration
First Name
*
:
Last Name
*
:
Street Address
*
:
City
*
:
State
*
:
Zip Code
*
:
Home Phone
*
:
Mobile Phone:
Email address:
Congregation Name and Location
*
:
Gender
*
:
Dietary Preference:
*
:
Omnivore
Vegetarian
Vegan
Special Needs (dietary or otherwise)::
Role
*
:
DRE
Minister
Youth
Adult Advisor
Other
I need home hospitality:
yes
no
I will stay at the church:
yes
no
I need a map and driving directions.:
yes
no
I need a ride from DFW airport.:
yes
no
My flight information:
airline: flight #: arrival time Friday: departure city: departure time Sunday:
Registration Fee covers all expenses except for hotel.
*
:
$175 postmarked by 4/7/08
$200 postmarked after 4/7/08
$125 youth rate postmarked by 4/7/08
$150 youth rate postmarked after 4/7/08
I will have dinner on Friday night ($5):
yes
no
Total Due
*
:
Payment Method
*
:
Verification:
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