Name: *

First Name

Last Name

Mailing Address: *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone: *

(###)

###

####

RETREAT - Check ONE: *

March 21 (10AM) - March 23 (4PM)

YES - I am definitely interested in serving at Retreat.

MAYBE - I am unsure of my schedule yet.

NO - I am not able to serve at Retreat.

I have questions before I commit. Please contact me.

CAMP - Check ONE: *

YES - I am definately interested in serving at Handi*Camp this Summer.

MAYBE - I am unsure of my schedule yet.

NO - I am not able to serve at Handi*Camp this year.

I have questions before I commit. Please contact me.

If YES or MAYBE:

Please check which week(s) you would be available to serve:

ALL SESSIONS

June 2 - 4: Challengers - Session 1

June 5 - 7: Challengers - Session 2

June 9 - 11: Challengers - Session 3

June 16 - 18: Explorer Gals

June 19 - June 21: Explorer Guys

June 23 - 25: Voyagers

June 30 - July 2: Adventurers

July 3 - 5: Seekers & Discoverers

July 7 - 9: Conquerors & YABC