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Kids Kongress Application Form
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Date  

Church Name             Federation


Delegate Type: (choose 1)


 Male or Female Group:

Male       Female


Chaperone 

Name                         Address                              Email                       Phone            Age   T-shirt



Delegates:            No:

Name                         Address                              Email                       Phone            Age   T-shirt

Name                         Address                              Email                       Phone            Age   T-shirt

Name                         Address                              Email                       Phone            Age   T-shirt




Payment Method

  Check     
   Money Order   
  Debit/ Credit Card


* Checks or money orders must be received within 1 week of submission otherwise reservation will be cancelled.
* Debit/ credit card payments will be contacted within one week to complete transaction.