2019 Fall Retreat Registration

Name

This address will receive a confirmation email

Cell Phone

Parent's Phone (if under 18)

Address

I am a

Mid High Student High School Student College Student Young Adult (not a college student) Other Adult

I plan on leaving with the

3 PM Group (mostly college students and worship team) 5 PM Group

I can take my vehicle

Yes No

My vehicle can carry this many people total 1 2 3 4 5 6 7 8

I understand that I still have to turn in the Sivells Baptist Camp form and the First EFC Medical Release, which needs to be notarized. These may be picked up at the table in the back of the sanctuary.

Yes

Please select your payment option. You can pay with a check, cash, or credit card. If you are paying with a check, please make your check out to “First Evangelical Free Church” and write the name of the person you are paying for and the word "retreat" in the memo line. Please put this in one of the offering boxes in the main auditorium. If you are paying with cash, please place the cash in an envelope and write "retreat" and the name of the person being paid for on the outside of the envelope. Place the envelope in the offering box at the back of the main auditorium. If you would like to pay with a credit card, click on the arrow next to pay with check/cash and select the credit card option. Once the form has been filled out, press the submit button. Your credit card will be charged upon pressing submit, and there will be a page saying your form has been accepted.

Option

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2019 Fall Retreat Registration

Description

Please Fix the Following