Online Registration Form

Home Missions Family Conference - June 28-20, 2010

Please fill out the appropriate blanks and hit the Submit button at the bottom of the form.

Name:
Street Address:
City:
State:
Zip:
Phone:
Email:
Home Church:

Cost Calculations 
Individuals at $75 ---
A Family at 125 (includes two children)---
Number of Children under 16 years old (2 max, rest free) at $25---
Number of young adults over 17 in family at $35---
Accommodations Yes/No entry 
Tenting or Campers $5/night---
Bunkhouse bed $10/night---
Private Bunkhouse $50 (if available)---
Add a note to the Organizer (Steve Doe)

    Please send your deposit of $50 by 7 June 2009 to Mr. John Jamison, PO Box 91, McDowell, VA 24458.
    Make your check out to "MRCC" and indicate "Home Missions Conference"
    Thank you and the Lord bless.