LOMT 2012 All Age Event Registration Form

All required fields are marked with an*
Guest Name: First* Last*
Birthdate (if minor): Mo Day Year ( Please use numbers:Example 12 / 17 / 2002)
Gender: *

Home Mailing Address:*
Home City:* State:* Zip:*
Home Church and City:

Daytime Phone:* ( ) -
Cell Phone: ( )- Evening Phone: ( )-

E-Mail address:* I request confirmation packet by:* Email Regular Mail

For Family Events, please list the names of all participants (and date of birth for children under 18).



For individual events if a cabinmate or roommate is requested, please list below:



Events

Total Fee:*

Check housing option where appropriate:
NOT ALL OPTIONS ARE AVAILABLE FOR EVERY EVENT
See Event Description for appropriate options

Camp Lone Star Motel Style Cabin/Dorm:
Only one or two people per room
Up to three or four people per room
No restriction on number per room

Offsite RV Retreat Campgrounds:

Rig Type:

Popup
Fifth Wheel
Motorhome
TT

Length of Rig:

Slideouts:

1

2

3

other

Hookups requested:

Water

Sewer

Electrical

         Minimum amps required:

         20

         30

         50

         other