Boom Registration Mission Outreach – August-May Application Participant Name * Name of Church UMC Conference, if applicable N/aCentral Appalachian MissionaryWestern North CarolinaFloridaHolstonKentuckyMississippiNorth AlabamaNorth CarolinaNorth GeorgiaSouth CarolinaSouth GeorgiaTennessee-Western KentuckyVirginiaOther Phone Number * Is this your cell, work, or home number? * Email * Mailing address * Mailing address Mailing address Mailing address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Is this your first BOOM week? * Yes no If yes, how did you hear about BOOM? Dates Registering: * April 6-11, 2025September 28- October 3, 2025 A deposit of $85 per person is due along with this registration form. The final payment is due 30 days prior to arrival (either March 3 for April dates or August 28 for fall dates). If you need to cancel for any reason before 30 days prior to your arrival, you can receive a full refund or choose to rollover your paid amount to a future missions experience. If you need to cancel 30 days or less prior to your arrival, your $85 deposit will be nonrefundable. The remaining balance can be refunded or rolled over for a specific amount. Cost: $425/person (2 adults/room) or $450 (single). Includes 13 meals, project materials, programming. Commuter rate ($330) available for local residents. Choose option * Overnight- 2 adults/roomOvernight- Private RoomCommuter T-shirt size * Dietary needs/restrictions- please be specific * FIRST DEPOSIT INCLUDED: Number of participants * Total amount due * Payment options Mail in paymentPay with PayPalUse this dropdown to select how you are paying, on-line or by mail I understand and agree to the schedule outlined above. Signature: * signature keyboard Clear Date * To make your payment on-line, use the PayPal link below; payment will be confirmed after payment is received. You do not need to have a PayPal account. Select the option to ‘pay with debit or credit card’ to complete your payment. If you select to mail in your payment, you must still submit “PAY WITH PAYPAL” but you will bypass PayPal and your application will be submitted. You will receive a confirmation on the next screen. Pay with PayPal Start Over If you are human, leave this field blank.
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