EmailMe Form - Fellowship in the Smokies

Name *

First Last

Male/Female

Male

Female

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Home phone

### - ### - ####

Cell phone

### - ### - ####

Email *

I am requesting to bring children

yes

no

If yes, please complete the following section

Child 1 name

First Last

Age

Birthday

MM / DD / YYYY

Child 2

First Last

Age

Birthday

MM / DD / YYYY

Child 3

First Last

Age

Birthday

MM / DD / YYYY

Preferred form of contact *

Please note: We will be e-mailing you with all important details pertinent to this event.

Home church name *

Home church city *

Home church state *

Date of arrival *

MM / DD / YYYY

Arrival time *

HH : MM AM/PM

Date of departure *

MM / DD / YYYY

Departure time *

HH : MM AM/PM

1st time guest *

yes

no

If no, when did you last attend (month/year)

MM / YYYY

I am bringing my spouse *

yes

no

If yes, spouse's first and last name

I have invited the following guests *

Fellowship in the Smokies is designed for the purpose of introducing people to CBM who are not familiar with the work. Because of this, we ask each returning guest to bring at least two new guests.

Any physical limitations *

yes

no

If yes, please explain

Dietary restrictions or allergies *

yes

no

If yes, please explain

Notes/questions

Referred by (if applicable)

If single, are you willing to share a room with someone you don’t know?

Yes

No