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Registration Information - Please complete and return promptly
*
Indicates required field
Pastor's Name
*
First
Last
Wife's Name
*
First
Last
Mailing Address
*
Line 1
Line 2
City
State
Zip Code
Country
Cell Phone Number
*
Email
*
Church Name
*
Church Phone Number
*
City
*
Number of Years in Ministry
*
State
*
Expected Arrival (Choose One):
*
Thursday, October 6th
Friday, October 7th
Saturday, October 8th
Meals (Choose all that apply):
*
Bon Fire/Thursday
Breakfast/Friday
Lunch/Friday
Dinner/Friday
Breakfast/Saturday
Lunch/Saturday
Overnight Accommodations?
*
Yes
No
Food allergies?
*
Yes
No
If yes, please list food allergies:
*
Are there any special needs we should be made aware of?
*
Please indicate your choice for a Scenic Camp Tour - Choose One
*
Friday Morning - 9:00 a.m.
Friday Afternoon - 1:00 p.m.
No thank you
Please indicate your choice for a Pontoon Boat Lake Cruise - Choose One
*
Friday Morning - 9:00 a.m.
Friday Afternoon - 1:00 p.m.
No thank you
I would like to meet one-on-one for prayer, counsel, and encouragement - Choose One
*
Friday morning with Bro. David Revelle
Friday afternoon with Bro. Gene Mims
No thank you.
* A meeting time will be emailed to you once your Reservation is confirmed. Thank you!
The deadline to Register is Friday, September 23, 2022!
Reservations for suites, rooms, and cabins will be accepted on a first-come basis so please register as soon as possible to ensure your place.
Meals and lodging are complementary.
Be sure to click the Submit button to guarantee your reservation.
Submit
Home
About
Meet the Founder
Statement of Faith
GETAWAYS
I'M LOOKING TO GETAWAY
I'M SUBMITTING OUR MINISTRY INFO
Prayer Requests
Podcasts
Podcast Archives
Devotionals
GIVE
Make A Secure Donation
In Honor/In Memory
Host a Fundraising Event
Contact
