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Assemblies of God Northern California and Nevada District

2007 Baja Bash: Registration Details

To register for the 2007 Baja Bash, 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 all that apply)

Golf Tournament
Jet Ski Rental
Horseback Riding

Waiver Form
Every registrant must read and sign the liability statement included in this waiver form and mail the form to the District Resource Center (Adobe Reader required).