Registration
Event Time: 7pm February 22nd - 24th 2019
Event Address: Various Homes
Contact us at (334) 365-7500 or jdersch@eastmemorial.org

Please fill out a new form for each student.
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Student Must Sign Up By February 6th to receive a t-shirt
Student Name (First, Last) *
Parent Email *
Grade *
Gender *
T-shirt size (Guaranteed if registering by February 6th) *
Dietary restrictions *
Please Bring Bible, Pen, Clothes, Sleeping Bag, and Toiletries
Be sure to have a parent consent form and medical release form for 2019 on file at the church.
Anything else that we should know?
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