J4F Edward John/Fearless Living Excursion Registration Form

Contact Information

Your Full Name:

Home Phone:

Cell Phone:

Work Phone (if applicable):

Email:

Confirm Email:

Number of people in your group:

Youth Group Challenge

Are you participating in the Youth Group Challenge?

Yes No

If yes, name of your youth group:

Number people in your youth group (approximately):

Please review your input — Have you completed all sections? Please check for correctness. When you are finished, click the button below:

Lodging Information

Are you lodging at the Conference Center, or off site? Blue Ridge Assembly Conference Center Other Location

Have you already secured your reservation for lodging? Yes No

Excursion Details

Number people registered for white-water rafting:

Number people with tickets reserved for the Biltmore Estate:

Would you be willing to volunteer some of your time? (if yes, we will contact you in advance) Yes No

In the text area below, please provide additional information and/or outline special needs requests: