Old Presbyterian Meeting House: Home: 2010 Workcamp Registration

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2010 Workcamp Registration To sign up for the West Virginia workcamp, complete this form and return it to the church office with the deposit amount specified below. The Registration Deadline is May 1st, and places will be reserved on a first-come, first-served basis. Deposits are refundable through ‘balance due’ date; after this dates, no monies will be refunded. Registration isn’t complete until your deposit is received in the church office (write “workcamp” on the memo line of check) * Required Errors Shack Neighborhood House, Pursglove, West Virginia, July 11-16, 2009 Estimated $250 per person (double occupancy); $300 (single) $100 deposit due by May 1st (registration deadline); balance due by June 15th Today's Date * First Name * Last Name * Email Address * Home Phone * ( ) - ext. Work Phone ( ) - ext. Mobile Phone ( ) - ext. T-shirt size * Family members or friends also registering? (Each registrant must complete a separate form) List any notable construction, language or other skills: If you are youth/minor please complete following: Youth Age during workcamp: Youth Grade (entering): Parent name(s): Youth â€“ Who will be your sponsoring adult? Parent Phone numbers (Work) ( ) - ext. Parent Phone Number (Home) ( ) - ext. Parent Phone Number (Mobile) ( ) - ext. Parent Email:
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Old Presbyterian Meeting House

323 South Fairfax Street, Alexandria, VA 22314

703-549-6670