P4C23-Reg
Info
Name
*
First Name
Last Name
Email
*
example@example.com
Gender
*
Male
Female
Birthday
*
-
Month
-
Day
Year
Date
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Food Allergies
Do you have Any Food Allergies
*
No
Yes
IF YES, please let us know the details of your food allergies
Housing Request
Would you like to room with a friend?
Activities Sign-Up
Pre-sign up for activities. You can check out the Schedule for more info. Climbing Wall spaces are limited. Please sign up if this is something you would like to do.
Climbing Wall
*
Please Select
No thanks
Yes, please
Volleyball Tournament
*
Please Select
No thanks
Yes, please
Did a Friend Invite You?
Please give us the first & last name of who invited you?
T-Shirt (FREE w/Reg)
Shirt Size
*
Please Select
Small
Medium
Large
X Large
Airport Transportation
Airport Transportation from CMH ONLY, October 26 & 29. Linens are included which contain bedding, washcloth, and towel. An email will be sent to you to get your flight info.
Do you Need Airport Trans?
*
No
Yes - $40
Payment
Payment Method
*
CC
Venmo
Total Amount Due
VENMO PAYMENT LINK
ENTER TOTAL
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USD
Description
Submit
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