Event Registration
Event Title: Celebrate Countryside!
Note: To register additional people, provide the following information and continue to the next page.
Personal Information - Step 1 of 4
Salutation
Mr.
Mrs.
Miss
Ms.
Rev.
Pastor
Dr.
*
First Name
*
Last Name
Address
City
State
Zip
Country
Home Phone
Work Phone
Mobile Phone
*
E-Mail
Re-Enter E-Mail
Comments
Event Fees
Adult ($8.00 per person):
1 person ($8)
2 people ($16)
3 people ($24)
4 people ($32)
JO Student: 7th - 12th grade ($7.00 per person):
1 student ($7)
2 students ($14)
3 students ($21)
4 students ($28)
MC Student: 1st - 6th Grade ($5.00 per person):
1 student ($5)
2 students ($10)
3 students ($15)
4 students ($20)
PC Student: Age 3 - Kindergarten ($3.00 per person):
1 student ($3)
2 students ($6)
3 students ($9)
4 students ($12)
Toddler Community: FREE:
1 student ($0)
2 students ($0)
Note: You may register additional people on the next page.