Request to attend the Walk to Emmaus – BRAZOS VALLEY EMMAUS COMMUNITY

Today's Date!

Date

Our community website is an excellent source of information. Please check it out at bvemmaus.org

All information is necessary for your proper placement on the Walk.

Name*

Male or Female*

MaleFemale

Date of Birth*

Date

Name for your name tag*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone*

Marital Status

Occupation

Church Name*

Denomination

Church: City / State / Phone Number*

Pastor's name*

Pastor's email*

example@example.com

*The Walk to Emmaus is not intended for non-Christlans, but rather to strengthen those who already believe in Jesus Christ. People accepted for the Walk are expected to be active members of a Christian congregation. All exceptions MUST be approved in advance by the Community Spiritual Director. Please speak with your sponsor, if necessary, before completing this form.

About Your Sponsor

Sponsor Name*

Sponsor Email*

example@example.com

Sponsor Phone*

Please enter a valid phone number.

Walk Related Questions

Has the Walk been explained to you, including post Walk activities?*

*If you do not understand this question, talk to your sponsor before you complete this form.

Are you on a special diet?*

If yes, explain

Are you on medication?*

If yes, explain

Do you have any health problems or physical limitations that may affect your attendance or require special assistance at the Walk? If yes, please explain

*It is important that we know if you have any special needs or challenges. It is rare that any such need cannot be met so that you can fully participate in the Walk; however, we need to know your what your needs are as far ahead as possible so that we can make preparation for you. This information will only be released to those who are responsible for meeting your needs.

Walk date requested

Date

If the Walk you have requested is full, would you like to be put on a waiting list?

If yes, would you be able to attend with 2- or 3-days' notice?

The Walk to Emmaus fee is $225.00. What portion of the fee will be paid by:
You ($): You ;
Your Sponsor ($):Your sponsor;
Other ($): Other
Please indicate "other" by name: Other name

A $75.00 deposit is required when this form is submitted. Payment can be made by check or on-line by clicking here (be sure to select the correct men's or women's walk). Send checks to:

Registrar, Brazos Valley Emmaus Community
PO Box 10491
College Station, TX 77842

Next, your sponsor is required to submit the Sponsorship Form on the bvemmaus.org website or submit this form by mail.

In addition, an email will be sent to your pastor, explaining the Walk to Emmaus and requesting his/her signature to your request to attend the Walk. This signature represents the commitment of your pastor to work with you in developing your service to God after the Walk.

Applicant Signature

This form can be completed online and automatically sent to the registrar by choosing SUBMIT, or may be printed, completed and mailed to the address below.

Registrar, Brazos Valley Emmaus Community
PO Box 10491
College Station, TX 77842

Thank you for submitting this Request to Attend the Walk to Emmaus.