Volunteer Registration Form
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Format: (000) 000-0000.
E-mail
*
example@example.com
Date of Birth
*
-
Month
-
Day
Year
Date
Gender
*
Male
Female
Name of your home church:
*
Tell us about yourself and why you would like to serve:
*
What is your experience related to working with people with disabilities? **No experience is necessary.**
*
Retreat Location
*
Please Select
Oregon - Cannon Beach, 4/16-19
Alabama - Shocco Springs 10/1-4
Canada - Muskoka Bible Centre 10/22-25
California - Cambria Pines Lodge 11/12-15
Texas - Lakeview Bible Camp 12/3-6
Ways to Serve
*
Please Select
One-to-one, Buddy
General help
Kids program
Where needed
Other
Food Allergies
*
None
Gluten Free
Dairy Free
Nut allergy
Other
If "other", please detail below
T-Shirt Size
*
XS
S
M
L
XL
XXL
REGISTER
Should be Empty: