Name of Student: Name of Parent (s):
Address: City: Zip Code:
Home Phone: Cell Phone: Email:
Which ministry is your student currently involved with? Tiny TotsKids KonnectionThe CurrentRevolutionNot Currently Invovled
Is your student a regular attender or a guest? Regular AttenderGuest
Which event are you interested in signing up for? MS Winter RetreatHS WInter RetreatBelieveMOVEExperiential SummerNomadAscentCSFE
Emergency Medical Form
When you submit this form, you are signing you or another up for the stated event. You will receive further information on the event as the date nears. Thank you and stay tuned!
You will receive an opportunity to pay for this event online once this form is submitted.