3AM Symposium + Santa Cruz Mission Trip

Central California Mission Trip & 3AM Symposium

Registration Options*

Name*

Email*

Phone Number*

Coupon Code

Lodging Options*

Have you attended a SOLI mission trip before?*

Your T-Shirt Size*

Is your Spouse Coming?*

Are You Registering Any Children?*

Are You Registering Any Children for this event?*

Children Ages 13-17

($50.00/ea.)

Children Ages 5-12

($30.00/ea.)

Children Ages 5 & Under

($0.00/ea.)

What days will you attend?*

Tuesday
Wednesday
Thursday
Friday
Sabbath
Sunday
Monday

Would you be willing to be a driver for the mission trip, if needed? (Gas will be paid for)*

Yes
No

Are you a baptized SDA?*

Yes
No

Which church do you attend primarily and where is it located?*

Do you have specified medical conditions? (If yes, please specify)*

Are you allergic to any food? (If yes, please specify)*

Media Release Form*

I, the undersigned, agree to the terms above.

Volunteer Liability Form*

I, the undersigned, agree to the terms above.

Child-Care Waiver*

I have read and agree to the terms above.

Emergency Contact

Name*

Email

Phone Number*

Reference

Pastor's Name

Pastor's Email

Pastor's Phone Number

Billing Information

Name*

Use a previously saved card

Credit Card*

Visa
Mastercard
American Express
Discover

Save this card for future use

Address*

Email*

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