Name of Individual registering

Name of Organization

Address

City, State, Zip

Organization's Phone (Please be sure to include area code.)

Contact Person

Contact person's email

Contact person's phone number

Contact person's cell phone number

Dates you plan to participate-(Arrival and Departure dates, please)

Cost package you plan to use

Number of adult participants

Number of youth participants

Please Note:  Students aged 12-17 years require 1 adult per 7 young people.  If students between 7 and 11 years of age participate, the adult-student ratio is 1 to 4.  Children under 7 must be accompanied by their own parent or legal guardian.

Comunity Block Parties (PM only)

Construction Ministry

Paint the Town

Soup Kitchen (AM only)

Nursing Home Ministry

Park Ministry

Performance Ministry

Prayer Walks

Sports Camps

Backyard Bible Clubs/Vacation Bible School