Jr. High Gathering Registration – Speakers/Musicians/Committee

Jr High Gathering Registration - Committee/Speaker/Musicians/Etc

Email(Required)

Name(Required)

First Last

Phone(Required)

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Emergency Contact(Required)

First Last

Emergency Contact Phone Number(Required)

T-Shirt Size(Required)

Hotel Needs(Required)

Please select the nights you need a hotel room.

Monday

Tuesday

Wednesday

Do Not Need Housing

Will family be staying with you?(Required)

Yes

Please share who will be staying with you and list their ages(Required)

First Name

Last Name

Age

Do you have any special dietary or mobility needs?(Required)

Such as food allergies? if no, please enter NA.

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