Mission Outreach Summer Group Registration form by Ricky Hill | Nov 3, 2023 | Latest News Mission Outreach - Summer Group Registration Church/Group Name * Pastor's name * Group Leader's name * Group Leader's email * Preferred mailing address * Preferred mailing address Preferred mailing address Preferred 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 mailing address: * Church Home If church mailing address is different than above, please provide here If church mailing address is different than above, please provide here If church mailing address is different than above, please provide here If church mailing address is different than above, please provide here City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal Church phone number * Mobile number of contact person * If UMC, is your church in the SEJ (Southeastern Jurisdiction)? Yes No Do you use text messaging? * Yes No Mission Dates * (Format: MM/DD/YYYY to MM/DD/YYYY The first deposit of $150 per person is due along with this group application form and must be received to hold dates. The final deposit is due 30 days prior to arrival, along with confirmation of the number of participants. If the registered group needs to reduce the number of participants, this change must be made at least 30 days prior to arrival. Any increase of participants must be made in consultation with Hinton Center. What is the number of adults on your mission team? * What is the number of youth on your mission team? * Total number of participants. * (this field will be automatically calculated based upon previous entries) Total Amount Due: * Payment Options * Use this dropdown to select how you are paying, on-line or by mailMail in PaymentPay with PayPal Has your group participated in Hinton Center Mission Outreach before? * Yes No If no, how did you hear about Hinton Rural Life Center? o 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 will bypass PayPal and your application will be submitted. If you are human, leave this field blank. Pay with PayPal
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