Executive Directors Gathering Registration

Registration

First Name

Last Name

Outdoor Ministry Organization

Position Title

Name for nametag

Prefered Pronouns

Street Address Line 1

Street Address Line 2

Town

State

Zip

Cell Phone xxx-xxx-xxxx

Email Address

Lodging / Transportation Single @ $550 Double @ $500

MSP Airport Shuttle Service - $35

Roommate Request Make sure roommate requested is requesting you as their roommate

Special Requests

Dietary Restrictions