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Fuel the
Fire IX
Youth Rally



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Carrie Iverson

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Fuel the Fire IX

"Amazing God"


November 4 and 5, 2005
Highland Academy Gymnasium, Portland, TN

If you have any questions, please email
Michael Smith.


Friday, November 4
7:00 p.m. - 10:00 p.m.
Sabbath, November 5
10:00 a.m. - 10:00 p.m.

Please note the following:

  1. A supervising adult must accompany any youth spending the night, unless they get clearance from one of the school deans. (At least one adult for every ten youth)
  2. All accommodations and meals are free for 2 sponsors per group only.

** All overnight accommodations must be
made by November 1, 2005 **

If you have any questions, please email
Michael Smith.



Student's First Name:

 
Student's Last Name:

 
Student's E-Mail Address:

 
Student's Age:

 
Student's Gender

Male Female

 
Student's Grade in School:

 
Associated Church/School

 
City

 
State  
Phone (XXX-XXX-XXXX)

 
Adult Sponsor

 

* All Fields are required under "Student Information"


If you are going to the meetings only, simply answer "No"
to the following questions and enter $0.00 as the cost.


Overnight Lodging on Campus
$5.00 per night for lodging at Highland Academy
Friday Night - $5.00 . . . . . . . . . . . . .
Saturday Night - $5.00 . . . . . . . . . . .

Yes No
Yes No

Meal Tickets
Each Meal requires 1 Meal Ticket = $5.00 per meal.
Sabbath Breakfast - (8:00 a.m.) - $5.00 Yes No
Sabbath Lunch - (12:15 p.m.) - $5.00 Yes No
Sabbath Supper - (5:00 p.m.) - $5.00 Yes No
Sunday Brunch - (10:00 a.m.) - $5.00 Yes No
Estimated Cost - Add up Lodging and Meal Costs for Amount Due upon Arrival  

If you are going to the meetings only, simply answer "No"
to the questions above and enter $0.00 as the cost.


Comments




If you have any questions, please email
Michael Smith.

If for some reason you are not able to submit this by regular means,
you may print the form out and fax/mail it as follows:

Highland Academy
Attn: Michael Smith
211 Highland Circle Drive
Portland, TN 37148

Fax (615) 325-4824





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