Register, Choose Life Congregation

Name *

First

Last
Street Adress
Apt. #
City
State
ZIP
Phone Number
Email Address *
Number Attending *
Number of Tent Sites Requested *
Number Eating Meals (Over 12 years of Age) *
Number Eating Meals (Under 12 Years of Age) *
Arrival Date *
Departure Date *
Any additional information, requests, concerns, or questions
*

I hereby consent to the Waiver Agreement I hereby agree to the Code of Conduct