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DiscipleNOW Weekend

Date

November 15 – 16, 2019
Category
Youth Ministries

What DoesSubmissionLookLike?

DiscipleNow Weekend, November 15 & 16

Click to open Informational Brochure

Register Online Below

Number of Students and Adults Attending for Food and Shooting *

Please indicate the number attending for food and shooting.

Number of Students and Adults Attending Food and Fishing Only *

Please indicate the number attending for food and fishing only.

Name of Student/Adult *

First

Last

Date of Birth//

For first-time participants only!

Name of Student/Adult

First

Last

Date of Birth//

For first-time participants only!

Name of Student/Adult

First

Last

Date of Birth (copy)//

For first-time participants only!

Name of Student/Adult

First

Last

Date of Birth (copy) (copy) (copy)//

For first-time participants only!

Name of Student/Adult

First

Last

Date of Birth (copy) (copy)//

For first-time participants only!

Name of Student/Adult

First

Last

Date of Birth//

For first-time participants only!

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Age or ages

For first time participants only!

Signature of Parent/Guardian *

Emergency Contact Phone *

Alternate Emergency Contact Name *

First

Last

Phone *

Total

$ 0.00

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