JOLT 2019 Registration
Registration for junior high youth retreat October 25-27, 2019 at Laurelville Camp, Mt. Pleasant, PA.
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Church Name *
Group Leader Name *
Phone Number *
Email Address *
Name(s) of Male Counselors *
Name(s) of Female Counselors *
Name(s) of Male Students *
Name(s) of Female Students *
Number of Counselors and Students Attending *
Amount Owed - $99.00 per person *
Pay the deposit of $20 per person or pay the balance. *
Amount paid *
See payment options below. If you choose to pay with a credit card, a link from PayPal will be sent to you within 2-3 business days.
Payment options *
Thank you for registering for JOLT 2019!
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