First United Methodist Church Rockwall Texas

Summer Junior High Youth Mission Trip

to Dallas, Texas w/ C2K (Connect to the Kingdom)
July 15^th-30^th, 2010

Deposit due June 6^th, 2010 - flyer & information found below or download here

I've already registered but need to print the forms & packing list again...

Participant Name:      

I am a youth   adult parent/chaperone

Grade (as of Spring 2010):  <blank>6th7th8thAdult Chaperone

Address: 

City:                 Zip: 

Phone: 

Email: 

$100 Youth / $50 Adult Deposit due Sunday 6/6/10
additional $50 Youth Deposit after Sunday 6/6/10

Total Cost for Youth with registration before 6/6/10 $250
Total Cost for Youth with registration after 6/6/10 $300
Total Cost for Adult $150

Registration is not complete until deposit is turned into the church or youth office. 

Do you want a Mission Trip T-Shirt?

       I want a Rockwall Youth Mission Trip T-Shirt

                  Adult sizes   NoneSmallMediumLargeX-LargeXX-Large  

Do you have a friend who wants to go?
           Name -  

My 2010 church medical form is on file or I need a medical release (can be found on following confirmation page)

Please list any previous mission trip experience: 

I have tools:  hammer, apron, paint brush, gloves, etc.