WICHITA QUAKE

Group Information

Registrar Name

Registrar Email

Registrar Cell Phone Number

Group Leader's Name

Group Leader Email

Group Leader Cell Phone Number

Church Phone Number

Church Name

Church Address

What Denomination is Your Church

How Did You Hear About Quake?

Middle Schoolers (Late)

($159.00/ea.)

High Schoolers (Late)

($159.00/ea.)

Adult Leaders (Late)

($159.00/ea.)

Call (920) 202-3126 for hotel room inquiries. Rooms are not guaranteed after the Standard deadline.

Order Total

$0.00

Donation Amount

Suggested Amounts

What fund would you like your donation to go towards?