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Pre-Registration Form Step 1

Pre-Registration Form Step 1 Request Form

Church / Org Name:

Group Leader:

Church / Org Address:

City / State / Zip:

Church / Org Phone:

Group Leader Email:

Desired Cities:

Desired Dates / Season:

A $500 (group size 1-29 people) / $1,000 (group size 30+ people) non-refundable deposit is required at this time to lock in your rate

Deposit / Group Size:

	Deposit: $500 Group Size: 1-29 people
	Deposit: $1,000 Group Size: 30+ people

*non-refundable deposit is required at this time to lock in your rate:

Payment Type:

	Check *Make payable to: CityConnexx PO Box 11909 Denver, CO 80211-0909
	Credit Card We will contact you for your credit card info.

CityConnexx is sponsored by Compassion International. A program of YPN