"LIFTED UP"
February 10-11, 2012
Texico Conference Winter Youth Rally
El Paso, Texas

Date*Please put in today's date.

mm/dd/yyyy

Name*

First

Last

Address*

Address 1

Address 2

City

State

Postal code

Country

Home Phone Number

Cell Number

Email Address

What church do you attend?*

Registration Fee*
Regular: $20 (if registered by February 8)
Late: $30 (at the door)
Additional T-shirts (if available): $10

*Registration fee gives you access to all the events, meals and one t-shirt (while supplies last). Please register AS SOON AS POSSIBLE to guarantee a t-shirt in your size.

Hotel accommodations must be made by each individual youth group.

Please select which T-shirt size you are requesting.

Small

Medium

Large

X-Large

XX-Large

Please check all that apply.*

Age 13-17

Age 18-30

I am an adult chaperon

I am a Youth Leader at my church

Payment may be mailed to:

Texico Conference Youth and Young Adult Department
Attn: Barbara Reeve
P.O. Box 1366
Corrales, NM 87048

Payment can be made by cash, check or credit card. Checks must be postmarked no later than February 11. If you cannot make your payment by that date, please call the Conference to make payment by credit card at (800) 749-7851. PLEASE BE AWARE THAT REGISTRATION IS NOT COMPLETE UNTIL PAYMENT IS RECEIVED.

Comments

For more information please call the Texico Conference office at (800) 749-7851 or (505) 244-1611.

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2012 Texico Conference Winter Youth Rally Registration Form