Registration form 2009 Fees: $10. 00 per Pathfinder and Staff Club Name



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SOUTH ATLANTIC CONFERENCE

OFFICIAL PATHFINDER CLUB REGISTRATION FORM
2009
Fees: $10.00 per Pathfinder and Staff
Club Name____________________________________________________________________

Church Name__________________________________________________________________

Address_______________________________________________________________________

City_______________________ State___ Zip______ Telephone (____)________________

Pastor’s Name_________________________________ Telephone (____)________________
Director’s Name________________________________________________________________

Address_______________________________________________________________________

City_______________________ State___ Zip______ Telephone (____)________________
Club Staff

Deputy Directors:

_______________________________________________ Male____ Female____

_______________________________________________ Male____ Female____

_______________________________________________ Male____ Female____

_______________________________________________ Male____ Female____


Club Members _____ Male____ Female____

TLT Members _____ Male____ Female____

Staff Members _____ Male____ Female____

Master Guides _____ Male____ Female____



Does your club have the following?

Drill Team [ ] Yes [ ] No Members _____ Male____ Female____

Drum Corp [ ] Yes [ ] No Members _____ Male____ Female____

Bible Bowl Team [ ] Yes [ ] No Members _____ Male____ Female____

Other:

______________________________ Members _____ Male____ Female____



______________________________ Members _____ Male____ Female____

Additional Information:

______________________________________________________________________________

______________________________________________________________________________




Complete form in triplicate. Mail one (1) copy to the SAC Youth Ministries Department, mail one (1) copy to your Area Coordinator , and keep one (1) copy for your records. (PLEASE TYPE OR PRINT)
South Atlantic Conference Youth Ministries Department

P. O. Box 92447 – Morris Brown Station

Atlanta, Georgia 30314

Telephone: (404) 792-0535 Extensions 113 or 112

Female (Members) Male (Members)


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Amount Enclosed: $_____________

(NO PERSONAL CHECKS)

OFFICE USE ONLY OFFICE USE ONLY
Date Received ______________ Club _______________________ State _____

Total Members ______________ Money Order _________



Amount Received ______________ Check _________

Receipt Number ______________


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