FEJA TEEN RETREAT

FEJA TEEN RETREAT

To book for a place in the the camp, you must complete the form below accurately.
Your Name:

First NameLast Name
Birth Date:

MonthDayYear
Mobile Number:

Area CodePhone Number
Email Address:
Primary Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Select Camp shirt size:

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Parent/Guardian's Name:*

First NameLast Name
Contact Phone Number:*

Area CodePhone Number

Emergency Contact Information
Emergency Contact Name:

First NameLast Name
Emergency Contact Phone Number:

Area CodePhone Number
Relationship:
If payment is going to be online, please click next. If sending check please click submit. (Si el pago va a ser en lina, por favor de selecciónar next. Si va a enviar cheque por favor seleccionar Submit.)

Enviar pago a:

Gulf States Conference - FEJA

10633 Atlanta Highway, Montgomery AL 36117

My Products

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FEJA TEEN RETREAT$120.00

Total $0.00

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