Navidad A Reynosa Team Leader Form

We are very excited to see what God is going to do this year at Navidad A Reynosa, and we are looking forward to seeing you. To confirm your reservation, please complete this form and submit a deposit of $50 per person by October 1 to:

Upon This Rock International
P.O. Box 644
Willard, MO 65781

• Arrival date is December 27 with dinner provided.
• Departure date is December 30 with breakfast provided.
• Cost is $175 per person.

Group Information

Church/Group Name:

Address:

City:

State:

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Postal Code:

Leader Information

Leader Name:

Home Phone:

Cell Phone:

Email:

Other Information

Number in Group:

Please list any medical concerns (including food allergies):

500 characters remaining.

Please list any special skills or talents on your team:

500 characters remaining.

Emergency Contact Information

Contact Name:

Daytime Phone:

Evening Phone: