Program choice:
July 1 - July 12, Halifax
July 1 - July 12, Vancouver
July 1 - July 12, Toronto
July 22 - August 2, St. John's
July 22 - August 2, Toronto

Name of youth:

Gender: Male Female

Age:
(as of July 1, 2012)

Date of birth:

Address:

City:

Province:

Postal code:

Phone number:

Email:

Name of church group:

Special Dietary Needs or Allergies:

Name of parent:

PAYMENT AND REFUND POLICY
GO Site reservations are secured by a $100.00 deposit per person.  This payment is due 21 days from the date of registration.  The remaining balance is due 30 days prior to the commencement of the mission program.