Music in the Mountains

Registration Form

Information

All spaces with * are required 

* Name

* Address

Address Continued
* City * State * Zip

* Home Phone Work Phone

*E-Mail

Church Name, Town

Tickets for the event  are $15.00 before August 21, 2010

Tickets and Food Card only

Number of  Tickets

Number of  Food Cards

Lodging Options if Purchased by August 10

(includes food card, lodging and ticket price)

Number of Adult Participants needing Lodging                   Lodging Request

Tent one or two nights $29.00    

Cabin one night $36.00                                                            Cabin two nights $43.00

Enrichment Center One night $47.00                                        Enrichment Center Two nights $65.00

Number of Children Participants needing Lodging   

Enrichment Center One night Children (ages 6-10) $34.00        Enrichment Center two night Children (6-10) $39.00

This is the total amount you will be charged

P.O. Box 245, Jennerstown, PA 15547  |   Phone: (814) 629-6627

last modified: 24 January 2010 -- Copyright 2009 - 2010 Sequanota. All Rights Reserved.