Online Registraton Form

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Registrations have now closed       Please complete the form below to register (one household per form) Name of person paying:   Name is required Address of person paying: NB: We will send a receipt so that If the person paying the registration fee is a tax-payer they will be able to claim a tax rebate for 33% of the total fee.   Address is required Phone: Email:   Email is required  Invalid address     Church attended: Please select None Bays Baptist Church, Auckland Emmanuel Church, Auckland Grace Bapist Church, Christchurch Grace Reformed Baptist Church, Palmerston North Gracenet Community Church, Wellington Marchwiel Reformed Baptist Church, Timaru New Heights Reformed Baptist Fellowship, Rotorua Shore Baptist Church, Auckland Trinity Reformed Baptist Church, Hamilton Howick Baptist Church, Auckland Other (please enter the church name and location below) Please make a selection: if 'Other' is chosen enter name & location below.       How many people will be attending from this household? 0  1 2 3 4 5 6 7   Please select Please enter their names and details below: Name   Attending as Fee Please select Camper aged 13 Camper aged 14 Camper aged 15 Camper aged 16 Camper aged 17 Camper aged 18 Leader/Cook/Helper Child of L/C/H aged 0-3 Child of L/C/H aged 4-12 $ Please select Camper aged 13 Camper aged 14 Camper aged 15 Camper aged 16 Camper aged 17 Camper aged 18 Leader/Cook/Helper Child of L/C/H aged 0-3 Child of L/C/H aged 4-12 $ Please select Camper aged 13 Camper aged 14 Camper aged 15 Camper aged 16 Camper aged 17 Camper aged 18 Leader/Cook/Helper Child of L/C/H aged 0-3 Child of L/C/H aged 4-12 $ Please select Camper aged 13 Camper aged 14 Camper aged 15 Camper aged 16 Camper aged 17 Camper aged 18 Leader/Cook/Helper Child of L/C/H aged 0-3 Child of L/C/H aged 4-12 $ Please select Camper aged 13 Camper aged 14 Camper aged 15 Camper aged 16 Camper aged 17 Camper aged 18 Leader/Cook/Helper Child of L/C/H aged 0-3 Child of L/C/H aged 4-12 $ Please select Camper aged 13 Camper aged 14 Camper aged 15 Camper aged 16 Camper aged 17 Camper aged 18 Leader/Cook/Helper Child of L/C/H aged 0-3 Child of L/C/H aged 4-12 $ Please select Camper aged 13 Camper aged 14 Camper aged 15 Camper aged 16 Camper aged 17 Camper aged 18 Leader/Cook/Helper Child of L/C/H aged 0-3 Child of L/C/H aged 4-12 $   TOTAL registration fee: $ Payment by: Please select Cheque Direct Credit Credit Card via PayPal A selection is required Payment processing fee: $   TOTAL amount due: $ Optional Message: Please enter the image word:

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