Massanetta Registration Form

Massanetta Registration Form

Come join us for an amazing week in the mountains of Virginia. All current 5th-8th Grade youth are eligible for this trip. Dates: Thursday, June 22-Sunday, 25. Cost: $250 (Family Maximum of $400)
Youth One Participant Name

First NameLast Name
Youth Participant Two Name (if applicable)

First NameLast Name
Youth Participant One e-mail Address
example@example.com
Youth Participant Two e-mail Address (if applicable)
example@example.com
Caregiver Name

First NameLast Name
Caregiver e-mail Address
example@example.com
Caregiver Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
T-Shirt Size(s)
Special Dietary Needs/Restrictions

Registration Fees: If you choose to pay by check, don't select either of these boxes, and select Submit below.

Individual Massanetta Registration

Select this option to pay for one youth participant. This covers the cost of conference registration fees, housing, and all food once we arrive at Massanetta.

$250.00

Family Massanetta Registration

Select this option to pay for more than one youth participant. This covers the cost of registration fees, housing, and all food once we arrive at Massanetta.

$400.00

Total

$0.00

Credit Card

Should be Empty: