Complete the on-line registration form below

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:*

 

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

EVENT FULL



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



To contact the LOMT Registration Office:
Mailing Address: P.O. Box 457, La Grange, Texas 78945
E-mail Address: registrar@LOMT.com
Telephone Local: 979- 247- 4128
Toll Free: 800-362-2078
Fax: 979-247-4120

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