Women at the Well 2021 Registration Form
State / Province / Region
Postal / Zip Code
I am willing to help with [please select at least 2]...
Singing in a choir
Sharing a thought/testimonial
Leading a prayer group
Playing the piano
Playing another instrument (please provide details in comments)
Sharing another skill (please provide details in comments)
Do you require transport to or from the camp?
Can you provide transport to the camp?
For how many?
First aid certificate or nurse?
Have you organised a room of 4-5 people? (optional)
Yes (please list roommate names in the comments)
Room requests and other comments
Online Payment Form