Synod Youth Workshop

Youth in the Sun

FOR OFFICE USE ONLY

Amt. Rec'd. _________ Church Check_____ 

Amt. Due___________  Personal Check____

REGISTRATION FORM

SYNOD YOUTH WORKSHOP July 12-17, 2004

Name______________________________  Male___ Female___

Address________________________________________________

City___________________________ State______ Zip___________

Telephone__________________ Date of Birth________________

                                                                                               Month/Day/Year

Church____________________ City___________ Presbytery__________________

PLEASE COMPLETE:

       I will enter grade______ in September, 2004.  I am a 2004 high school graduate____.

       I am age 23 or over and will be an adult sponsor .

Enclose $60 Registration Fee
Send to:

Synod Youth Workshop                    _________________________________________
1925 E. Belt Line Rd., Suite 220           Signature of Pastor or Clerk of Session (REQUIRED)
Carrollton, TX 75006                      
                                                         _________________________________________
                                                                             Your Signature