Sponsoring Church or Association:________________________________________________
 

Contact Person (Mr./Mrs./Ms./Rev./Dr.):___________________________________________
 

Address:____________________________________________________________________
 

Contact Phone (day):______________________ Contact Phone (night):___________________
 

Dates Perferred: 1st choice:_______________2nd:_______________3rd:___________________
 

Age Range of Group:_____________________________(grades 7-12)
 

Will there be an Episcopal Priest traveling with your group?______________________________
 

If so, please list his/her name and phone number:______________________________________

                                                                       Total # of

                                                                       Adults & Youth Totals

Regular Weekend Program:   $35 X _____________ = ________

Saturday night (optional):       $10 X_____________ = ________

Historic St. Mary's City Tour $5 X _____________ = ________

Skipjack tour                      $15 X_____________  =_________

Total Due (add column at right)                                  = ________

Deposit Enclosed (1/2 of Total Due)                          = _________

Balance due at Registration (1/2 of Total Due)            = _________