55+ Trip Sign up form:
Please fill out form and select submit button at the end of form. Your reservation is not complete until deposit is paid. Call Candyce if you have any questions.405-273-2105.
First and Last name:
Address including zip
Home /Mobile number:
Contact name and number in case of an emergency:
Trip you are signing up for?
How will you pay?
Online (There will be a link below to take you to Vanco site to pay)
In office by cash or check.
I will ride with group
I will drive myself
I will be rooming with?( please put name here)
I have health insurance and will have information with me.
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Immanuel Baptist Church.
Terms of Service