M.A.P. Church Registration Form

Thank you for your interest in M.A.P. 2010. The deadline to register is November 18. A $75 deposit is due to our office by that day in order to be considered for next summer. We will contact you by November 30 to let you know if your group has been accepted to participate in M.A.P. 2010.

All form fields are required unless noted.

Church information Church Name

Address

City

State

Zip

Church Phone
Church Fax (optional)

Church Web Address (optional)

Primary Contact for M.A.P. First Name

Last Name

Daytime or home phone

Cell phone (optional)

Email

Secondary Contact for M.A.P. First Name

Last Name

Daytime or home phone

Cell phone (optional)

Email

Group information Estimated number of Middle School Youth (6-8th graders):
Estimated number of High School Youth (9-12th graders):
Estimated Number of Adult Chaperones: Estimated Number of Minibuses:

(Required: 1 adult for every 5 youth, Adults participate free)

Additional information for us to know (optional)

Note: Churches must provide a minibus (not a van) for every 15 people participating from their group. If you are unable to provide a minibus, we require an additional fee of $80 per student to help cover the cost of bus rental.