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Registration Form
1.
*

Name of Individual registering

2.
*

Name of Organization

3.
*

Address

4.
*

City, State, Zip

5.
*

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

6.
*

Contact Person

7.
*

Contact person's email

8.
*

Contact person's phone number

9.
*

Contact person's cell phone number

10.
*

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

11.
*

Cost package you plan to use

12.
*

Number of adult participants

13.
*

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.

MINISTRIES YOU MAY CHOOSE

14.

Comunity Block Parties (PM only)

PM
15.

Construction Ministry

AM   PM
16.

Paint the Town

AM   PM
17.

Soup Kitchen (AM only)

AM
18.

Nursing Home Ministry

AM   PM
19.

Park Ministry

AM   PM
20.

Performance Ministry

AM   PM
21.

Prayer Walks

AM   PM
22.

Sports Camps

AM   PM
23.

Backyard Bible Clubs/Vacation Bible School

AM   PM

Type in the text that you see above:

  

* items are required fields. 

Central Community Ministries
601 Green Avenue
Greenville, SC 29601
Phone: 864-232-9797
ccmsc@ccmsc.org
Mailing Address:
PO Box 2392
Greenville, SC 29602
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