College/Young Adult Houseboat Registration
June 16-20 

Name:

Address:

Phone:   Email:

Age:  Birthday:

Do you have an insurance card or policy number? (yes or no)

Will you or your family be able to contribute food to this retreat? (yes or no)

Make sure you are able to attend the packing meeting on Sunday, June 15 at 7:30pm. If you are not able to attend please contact Pastor Gerald asap at ga003@earthlink.net to make arrangements.