LOMT 2010 Pre Confirmation Registration Form

All required fields are marked with an*
Church Name:*
Group Name:
Church Mailing Address:*
City:* State:* Zip:*
Church Phone:* ( ) - Church Fax: ( ) -
Adult Leader:*
Position:* Day Phone:* ( )- Cell Phone: ( )-
E-Mail address:*

NOTE: If you do not have an e-mail, enter your first and last name in the e-mail field.

RETREAT PARTICIPANTS:
Total Number of Young People:* Male Female

Total Number of Adult Leaders:* Male Female

ALL GROUPS MUST HAVE AN ADULT LEADER ON SITE PROVIDING SUPERVISION DURING THE ENTIRE EVENT
Pre Confirmation Session:*

Pre-Confirmation 1, (Sept 10-11) Latham Springs
Pre-Confirmation 2 (Sept 17-19) Camp Lone Star
Pre-Confirmation 4 SESSION FULL
Pre-Confirmation 6 (Oct 1-3) Camp Lone Star SESSION FULL
Pre-Confirmation 3 or 5 (Sept. 17-19 or Sept. 24-26) St Paul Center-Wichita Falls
Pre-Confirmation 7 (Oct 8-10) Camp Lone Star

Length of Stay:

Deposit: A $25 per person, non-refundable, non-transferable deposit
is required to reserve space(s).
Total Number of people attending* X $25 = Total Deposit
Total Due:*