Crusader Awakening #6 Registration

Date: March 21-23, 2014
Location: Hoblizelle Camp, Waxahachie TX (1hr drive)
Cost: $50 [if you cannot afford the fee, contact Denise Phillips, dphilli@udallas.edu]

Before you begin this form, you will need your insurance info in front of you.

Your registration is NOT CONSIDERED COMPLETE until payment is received.
Please deliver cash or check in a sealed envelope to Campus Ministry or place it in campus mail, Box 700. Makes checks payable to "Church of the Incarnation" with "Awakening" in the memo space AND on the envelope.

We also need a copy of your insurance card, so please bring either a copy to Campus Ministry with your payment or your card so that a copy can be made.

    Contact Info

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    Personal Info

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    Relative & Emergency Contact Info

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    Medical Info

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    Remember...

    Your registration is complete when your payment is received. Please deliver cash or check and a copy of your insurance card in a sealed envelope to Campus Ministry, or place it in campus mail, Box 700. Makes checks payable to "Church of the Incarnation", with "Awakening" in the memo space AND on the envelope.