CAMPUS DAYS GROUP REGISTRATION:
Church Information
Church Name
Telephone ( ) -
Address
City, State Zip

Attendee Information
Name
Address
City
State
Zip
Phone
Grad Year
M/F
E-Mail
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
( ) -
Adult Sponsor(s) Attending
Name
Address
City
State
Zip
Phone
M/F
E-Mail
( ) -
( ) -
( ) -
( ) -
( ) -

If more space is required, please give the information on a separate submission of this form.