Registration Form To register for Covenant Gathering: 1. Complete the Fee Calculator Form (you Must upload this form as part of the registration process). 2. Please complete the information in this form. 3. Review information prior to pressing the Submit button. 4. After the Submit button has been pressed you will be asked to pay for your tuition via PayPal. Please remember to add 3% to cover the fees charged by PayPal.) Please upload your Fee Calculator file (*) Invalid Input Name (*) Please enter your name Email (*) Please enter an email address we can reach you at Phone Number(s) Invalid Input Address Invalid Input Church Name & City Invalid Input Presbytery or Denomination Invalid Input Specify any physical considerations Invalid Input Housing Preference (*) Weatherwood Lodge Pine Ridge Family Units RV CampgroundCommunter Please select housing choice If you wish to share housing, please indicate family Invalid Input Please provide the following information for each adult in your group: Name Age Group •18-25 •26-35 •36-50 •51-65 •66-75 •76+ Male/Female Adult Info Invalid Input Please provide the following information for each child under 18 in your group: Name Age Birthdate Male/Female Grade complete Spring 2010 Child Info Invalid Input Total Amount owed: $ (*) Please enter a numeric value. Do not include the '$' or ',' symbols. Payment Method (*) PayPal/Credit CardCheck to be mailed to Registrar Invalid Input If mailing a check, please send to David Fleming, Covenant Gathering Registrar 406 Silvercrest Terrace Beavercreek, OH 45440 937-429-5366 Enter amount - full payment or 50% deposit (if this is a hardship contact David Fleming ). Please add 3% if using PayPal. $: (*) Enter numeric value. Do not include the '$' or ',' symbols.