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Assemblies of God Northern California and Nevada District

2006 Apex: Registration Details

To register for the 2006 Apex, please complete the following form. When you click the Submit button, you will be taken to a page which will enable you to add various options to our PayPal shopping cart. If you have any problems, please don't hesitate to .

It is very important that the details you enter here (name, street address, etc.) match the information you enter into the PayPal shopping cart on subsequent pages. This will allow us to match your registration details with your payment.

Name:

Street Address:

City:       State:       Zip Code:
         

Phone:

Email:

Home Church:

I plan to attend these events:
(please check one or two that apply)

Fishing
Go Carts
Water Sports
Water Slide
Hiking