Theological Education With Youth

Troubling the Water

Saturday, April 10^th, 9 A.M. to 5 P.M. (Atonement Lutheran, Wyomissing PA)

This event is open to 9^th and 10^th graders nominated by their pastor or other staff leader.
Please include all information requested so we can best communicate prior to event.

Fields marked with an * are required.
Pastor Name:	*
Congregation:	*
Address:
City:
State:		Zip:
Phone:
Email:	*

1) Youth Name:	*
Address:
City:
State:		Zip:
Email:

2) Youth Name:
Address:
City:
State:		Zip:
Email:

3) Youth Name:
Address:
City:
State:		Zip:
Email:

4) Youth Name:
Address:
City:
State:		Zip:
Email:

5) Youth Name:
Address:
City:
State:		Zip:
Email:

Adult leader/driver (if different than pastor above)

Adult Name:
Adult Address:
Adult Phone:
Email:
The cost for one adult is covered by the youth registration. If second adult is necessary then extra $25 registration is required.

$25 per youth X = $

Make checks for either event payable to:

TEY (memo: Trouble the Water)

and mail to:

Theological Education with Youth
61 Seminary Ridge
Gettysburg, PA 17325

Registration is not complete until payment is received.

Our group would like to receive all communication for this event by email, rather than standard mail. (Check box for YES). **Email address for all participants required for this option.