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Registration Form


Complete (Step 1) Registration Form below and return along with $1,000 deposit to CityConnexx to secure your preferred dates and group rate.   A CityConnexx representative will then contact you to discuss your goals, match you to a ministry site, and begin planning for your custom design mission trip.
(Note:  Early Bird pricing is only extended prior to December 15th)

Registration Form complete with 50% payment, due 8 weeks prior to arrival date.
Final Registration Form and final payment is due 4 weeks before your arrival date.
Participant Medical/Release copies are completed 2 weeks prior to your arrival.

Registration Form

1. Contact Info

Church / Org Name:
Group Leader:
Church / Org Address:
City / State / Zip:
Church / Org Phone:
Group Leader Email:
Group Leader Cell Phone:

2. Group Info

Total number of people in your youth/college group:
Estimated number of people to attend this trip:
Type of Group: Junior High | Jr./Sr. High | College Group | Family Group
Who referred you to CityConnexx?:
Has your group, church, family or leader attended before: Yes | No
1 FREE registration with 10 paid for returning group leaders and/or churches

3. City & Dates

CityConnexx will match your group’s interests and talents with the needs of a ministry partner in our network. List the cities of interest and ability to travel to and we’ll match your group to a site that can accommodate your group. You will be contacted by CityConnexx to confirm your city, date, and ministry site.

Which city/cities are you interested in?:
Which weeks/season are you interested in?
(Recommended arrival Saturday, departure following Friday)

4. Registration

Select the plan/rate below that you would like to sign up for.

Rates Early Bird Registration (prior to December 15th)

7 days | 6 nights (early bird) $325.00
6 days | 5 nights (early bird) $300.00
5 days | 4 nights (early bird) $275.00
4 days | 3 nights (early bird) $250.00

Standard Rates (following December 15th)

7 days | 6 nights (standard) $350.00
6 days | 5 nights (standard) $325.00
5 days | 4 nights (standard) $300.00
4 days | 3 nights (standard) $275.00

Special Options

Do you have special needs/requests?: Yes | No

CityConnexx Ministry Site Provided Meals:

Meals can be provided for your group during your stay by our ministry site. Please list the number of meals you would like provided during your entire trip, add the total for EACH person to add to your overall package/cost. Should you choose to provide your own meals, a $50 facility fee will be applied for kitchen usage during your stay.

Meal
Served
Cost Per
Person
Numer of
Persons
Numer of
Meals
Meals
Total
Breakfast $5.00 X X =
Lunch $6.00 X X =
Dinner $7.00 X X =
Total of All Team Meals:

Total Cost Per Person

Total per person to be added to pricing above:

Deposit:

A $1,000 non-refundable deposit is required to pre-register your group and lock in your rate. This deposit will be applied to your final payment due 4 weeks before your arrival date.

Minimum Group Size:

A minimum group size of 15 is required for all mission trips.

If your final number falls below the minimum requirement, final payment for the minimum group size is required.

Cancellation Policy:

The Pre-Registration deposit of $1,000 is non-refundable should your group cancel.

The Registration and 50% payment due 8 weeks before your arrival date is non-refundable and is based on an estimated number of participants which can be adjusted with your final registration and will be applied toward your final payment.

The Final Registration and final payment due 4 weeks before your arrival date is non-refundable and is based on the final number of participants at that time. In the event an individual needs to cancel after Final Registration has been received, the entire fee is transferable to a new participant. New participants may also be added before your arrival date.

Late Charge:

If Registration and 50% payment is not received/postmarked 8 weeks before your arrival date, a 10% late charge will be added.

If Final Registration and final payment is not received/postmarked 4 weeks before your arrival date, a 10% late charge will be added.

3. Deposit & Payment:

Deposit:
Deposit: $1,000
*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.

Questions & Comments:

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  • This mission trip was so awesome....I can't believe it's already over. I loved taking food to the homeless, and painting at the church. Thank you for ...
    - Becca Neemeyer
 

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City Connexx | P.O. Box 11909
Denver, CO 80211-0909
Phone 817-914-2671

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