GROUP REGISTRATION FORM Church: City: 2017 Middle School Gathering Event November 17-18 Request: November 18-19 Synod, ELCA This is a form. Type in your information, then this form to “Fillable” send with your registration. You can also print this form and fill in the information by hand. General Information: Registration is first received, first accepted. If the event you register for is full, you will be contacted to see if you wish to attend on the alternate date. Registration closes November 6, 2017 OR WHEN EVENT FILLS Registrations are not accepted without deposit. Deposits are non-refundable. Same-sex substitutions are allowed. Registrations MUST include one adult leader for every seven (7) youth. Adult leaders MUST BE at least 21 years old. You MUST send health and release form with registrations. Keep a copy for yourself. Participant information must be included on housing form. Please refer to youth event brochure for registration information on this event. Primary Leader Information: All information will be sent to this name/address Cost (check one): Early Bird Registration: $66 Primary Leader: Postmarked on or before October 16 Address: Regular Registration: $76 City: Postmarked on or after October 17 Zip: Address is for Best Phone # Our group would like to be housed This is my: Home Work Cell with: Email Address: Church: Please add me to Youth E-Chat email list City: Fax # *We will make every effort to accommodate your request, though it is not guaranteed. Group Totals: PARTICIPANTS Totals T-SHIRTS Totals Totals Total Male Youth Small Total Female Youth Medium Pepperoni Total Male Adults Large Sausage Total Female Adults X-Large Cheese 2X-Large Total Pizzas: Total Participants Total Shirts: X $30 Deposit per (T-Shirts are X $6 each participant Adult Sizes) (Pizza payments are (Deposits are non-refundable) Total Registration Total Pizza Payment Deposit Enclosed: Enclosed: Please send one check, payable to MN Synod LYO Gathering Account.” “NE You can combine the Registration Deposit and Pizza Payment in one check. Last day to add to your pizza order is November 6.
Church: City: Event Request: November 17-18 November 18-19 GROUP REGISTRATION FORM 2017 Middle School Gathering Synod, ELCA This is a “Fillable” form. Type in your information, then this form to send with your registration. You can also print this form and fill in the information by hand. General Information: Registration is first received, first accepted. If the event you register for is full, you will be contacted to see if you wish to attend on the alternate date. Registration closes November 6, 2017 OR WHEN EVENT FILLS Registrations are not accepted without deposit. Deposits are non-refundable. Same-sex substitutions are allowed. Registrations MUST include one adult leader for every seven (7) youth. Adult leaders MUST BE at least 21 years old. You MUST send health and release form with registrations. Keep a copy for yourself. Participant information must be included on housing form. Please refer to youth event brochure for registration information on this event. Primary Leader Information: Cost (check one): Early Bird Registration: $66 Postmarked on or before October 16 Regular Registration: $76 Postmarked on or after October 17 All information will be sent to this name/address Primary Leader: Address: City: Zip: Address is for Best Phone # This is my: Home Work Cell Email Address: Please add me to Youth E-Chat email list Fax # Our group would like to be housed with: Church: City: *We will make every effort to accommodate your request, though it is not guaranteed. Group Totals: PARTICIPANTS Totals T-SHIRTS Totals Totals Total Male Youth Small Total Female Youth Medium Pepperoni Total Male Adults Large Sausage Total Female Adults X-Large Cheese 2X-Large Total Participants Total Shirts: Total Pizzas: X $30 Deposit per participant (Deposits are non-refundable) (T-Shirts are Adult Sizes) X $6 each (Pizza payments are Total Registration Deposit Enclosed: Total Pizza Payment Enclosed: Please send one check, payable to “NE MN Synod LYO Gathering Account.” You can combine the Registration Deposit and Pizza Payment in one check. Last day to add to your pizza order is November 6.
msg17_group_registration_form.docx