Application for Central Alabama Walk to Emmaus
$150 fee is charged for the weekend. Complete this form, Submit, including sending a $25 reservation fee, non-refundable and non-transferable, (make check payable to CAEC) and mail to: CAEC, P.O. Box 241571, Montgomery, AL 36124. The balance of $125 will be due on the first night of the walk on which you are scheduled to attend. Any questions, call or e-mail: Registrar for Men’s Walks: Sharon Truman (334-354-4382), sharontruman520@gmail.com. Registrar for Women’s Walks: Bonnie Coker, E-mail: Cokerbonnie04@gmail.com.
You may VENMO reservation or application fee to Emmaus CAEC@Emmaus-1
Name
*
First Name
Last Name
Name for Name Tag:
Address
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
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Idaho
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Maine
Maryland
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Ohio
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Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Age
*
Male or Female:
Male
Female
E-mail
Please provide if you have an e-mail.
Home Phone Number
*
Cell Phone Number
Spouse or Emergency Contact
*
Required
Emergency Phone Number
*
Occupation
Occupation
Home Church Name
Denomination
Pastor's Name:
Are you a Minister or Pastor? If so, please fill out the following:
Yes
No
Serving what church or retired?
Ministerial Title
If Married, Has Spouse been on Walk to Emmaus
Yes
No
If so, Walk # and Location
Type Walk # and Location (i.e. #193, Camp Alamisco)
I am on MEDICALLY SPECIFIED Diet?
No
Yes
I am taking special medications?
No
Yes
I have food allergies?
No
Yes
I have Physical Limitations?
No
Yes
I prefer a Lower Bunk?
No
Yes
If yes, answered above, please explain "Yes" answers:
I want to attend the Central Alabama Walk to Emmaus because:
I understand this signed application does not reserve a position on a particular walk, but does put me on a list for upcoming Central Alabama Emmaus Walks .
Please sign\type name here.
Date Signed by Applicant
-
Month
-
Day
Year
Please select date.
SPONSOR'S NAME
*
First Name
Last Name
SPONSOR's ADDRESS
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
SPONSOR's E-MAIL:
*
example@example.com
Sponsor's Home Phone Number
*
Sponsor's Cell Number
Sponsor's Home Church
Denomination
Attend Church Regularly:
Yes
No
If No, please explain
When and where did you Attend Walk to Emmaus?
Walk # and Where?
Notice:
By signing this below, I agree that I understand and will assume responsibilities of a sponsor and fully believe that my applicant is ready for his\her Walk to Emmaus! ** There are no Handicap Accessibility features of the Facility Rented By C.A.E.W. for the 72 Hour Emmaus Walk. Applicants must be physically able to go up and down stairs, walk between the large Gathering Room and Individual Rooms and Restroom Facilities without assistance during the 72 Hours of the Walk. *** I am acknowledging that I am aware there are no Handicap Accessibility Features at the Camp. Revised 1/21/2019.
Sponsor Signature:
Sponsor's Sign Agreement to notice
Date
-
Month
-
Day
Year
Date
SUBMIT
Should be Empty: