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2012 CONCLAVES ONLINE REGISTRATION
CLICK HERE TO VIEW THE PAPER VERSION OF THIS REGISTRATION FORM
Choose the Conclaves Session that you are registering for (complete separate registrations for multiple sessions):
*
Session B: Middle and High School, Mar. 2-4, 2012
Church Name
*
Church Address
*
Address Line 1
Address Line 2
City
State
Postal Code
Contact Person
*
First Name
Middle
Last Name
Phone
*
Phone Type
*
work
cell
home
Alternate Phone:
Alternate Phone Type:
n/a
work
cell
home
E-mail:
*
Do you have PYCC or TRAINED SMALL GROUP LEADERS that will be staying with your church?
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Yes
No
**Note: PYCC & TRAINED SMALL GROUP LEADERS will receive a separate registration form and will register and pay through the Presbytery. Please list the PYCC & Trained Small Group Leaders ONLY IF they will be staying with your church in the designated areas below.
# Female PYCC Youth Leaders (ONLY IF staying with your church)
# Female PYCC Adult Leaders (ONLY IF staying with your church)
# Male PYCC Youth Leaders (ONLY IF staying with your church)
# Male PYCC Adult Leaders (ONLY IF staying with your church)
LIST YOUR PARTICIPANTS AND CHAPERONES BELOW. DO NOT include PYCC leaders in this count.
# Female Youth Participants (Middle/Jr High)
# Female Youth Participants (High School)
# Female Adult Chaperones
# Male Youth Participants (Middle/JR High)
# Male Youth Participants (High School)
# Male Adult Chaperones
Total Participants & Chaperones
*
Deposit Due (Total Participants & Chaperones x $50):
*
Choose a method of Payment for the deposit amount:
*
Credit Card (enter information on the form below)
I will mail a check (may checks payable to Camp Cho-Yeh)
Mail Checks to: Camp Cho-Yeh, 2200 S. Washington Ave., Livingston, Texas 77351
If paying by Credit Card, complete information below:
Visa
Mastercard
American Express
Credit Card Number
Expiration Date (MM/YY)
CCV Code (Last three numbers on the back of the card)
Cardholder
First Name
Middle
Last Name
Billing Address
Address Line 1
Address Line 2
City
State
Postal Code
Presbyterian Conclaves
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