Summer 2025 Template

WHERE: Carolina Point — Brevard, NC

WHEN: June 07, 2025 - June 11, 2025

Departure: Saturday, 6/7/25 (early morning departure from Love Field Airport)

Return: Wednesday, 6/11/25 (late night return to Love Field Airport)

COST: $1,160, a deposit of $150 is required to hold your spot.

Deposit and registration is nonrefundable.

After completing this form, a confirmation will be sent with the information you have entered below.

Questions and Information

Contact at the Trip Leader/Capernaum Coordinator at:

903-746-7408 - [email protected]

Participant Information

Guest Type

Registration Options

Register with a deposit or full payment ($1,160.00)
Please select to make a deposit or full payment below. This will be paid by credit card.
Register with an offline payment/$150 deposit ($1,160.00)
To register without credit card information, select cash/check/offline. This option will also create a payment link for the full balance listed.

Participant Name

Date of Birth

Participant Phone

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Phone Type

Participant Email

Opt-in to receive email and text message communications.

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Participant Address

Gender

Male
Female

Additional Comment

Ethnicity

T-shirt Size

School

High School Graduation Year

Additional Comments

Parent / Guardian Information

Parent/Guardian Name

Parent/Guardian Phone

Phone Type

Parent/Guardian Email

Address is same as participant

Address

Would you like to cover the 2.5% credit card processing fee?

Total

$0.00

Participant Information

Parent / Guardian Information

Billing Information