Please fill out the following application. Anyone under the age of 14 will be accompanied by an adult at the events. Anyone under the age of 18 is required to have a guardian on camp grounds.

Deadlines for Discounted tickets is April 19th, 2010.
AFTER THIS DATE IT IS $75.

PLEASE MAKE ALL CHECKS AND MONEY ORDERS OUT TO:
CNY WESLEYAN DISTRICT MEN

SEND PAYMENT TO:

ATTN: MEN’S ADVENTURE WEEKEND 2010
GARY COMFORT
58 LEWIS STREET
GILLETT, PA 16925

Name

Phone Number

Email Address

Street Address

City

State and Zip Code

Church Affiliation

Check Which Day you would like to attend:

Friay and Saturday

Saturday Only

Please tell us of any special needs that you may have (Medical, Dietary, etc.)

Volunteers Needed

I want to volunteer at this event (All volunteers must fill out a separate registration form)

PAYMENT (Registration Price includes meals and housing)

Select your payment option:

$60 Adult(Before April 19, 2010)

$40 Youth(Before April 19, 2010)

I will pay $75 at the door

$30 Adult Partial Payment

$20 Youth Partial Payment

Make Partial Payments before April 19, 2010

HOUSING (Included in the price of the registration fee - no price reduction if it is declined)

Please select one:

I need housing [If you wish to be housed with a group or individual please specify below

Group or Individual

No housing needed

Please put my name and address in for CNY District Wesleyan promotional material

Please type the verification code