Joshua One Ministries

CR4C Jan. 2012 Team Member Registration Form

This form is for team members who have already signed up for our January 2012 evangelism team to San José, Costa Rica. If you are a member of our team, please provide this additional information, which we need to complete your airline reservation and begin planning our evangelism projects.

[If you are NOT a team member but are interested, please read this and complete the short pre-registration form at the bottom of the page: CR4C January 2012.]

All information will be kept strictly confidential. Thank you!

Your name (exactly as it appears on your passport!)

City, State

Your church

Email address

Date of birth (e.g., 05-25-80)

Passport No.

Which outreach team do you plan to work on?
Health clinics Construction Children's evangelism Not sure

HOUSING
Standard registration includes double-occupancy at the hotel (you can choose your roommate or we will assign one). Single occupancy is available for an additional $228, and triple occupancy is available at a savings of $30 per person. Please select only one of the following housing options:
Double occupancy: I have written my roommate's name in the field below. Double occupancy: Assign me a roommate. I want single occupancy at the higher price. I want triple occupancy: I have written my roommates names in the field below.

My roommate(s) is:

Thank you for providing this information! We are delighted to have you on our team, and look forward to spending eight great days of fellowship, outreach, hard work, worship and fun with you! God bless!

CR4C Jan. 2012 Team Member Registration Form