Celebration Kentucky Registration
Event Timing: November 3-5, 2017
Event Address: Kentucky Dam Village State Park
Contact Bob Palmer at (731) 644-0419 if you have questions

To be completed by youth minister or group chaperone. If you are an individual , please do not use the following form. Contact your group leader and let them submit the information for the group.

NOTE: Determine the number of males/females and shirts in each size that you need for your group before registering here.

Congregation Name *
Your answer
Address
Your answer
City, State, Zip
Your answer
Church Phone
Your answer
Group Leader Name *
Your answer
Leader's Email Address *
Your answer
Leader Phone *
Your answer
Number of Males *
Your answer
Number of Females *
Your answer
Shirt Sizes
Enter the NUMBER of shirts you need in each size for your group
Adult Small
Your answer
Adult Medium
Your answer
Adult Large
Your answer
Adult XL
Your answer
Adult 2XL
Your answer
Adult 3XL
Your answer
Special Requests or Comments
Your answer
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