Chalice Sparx 2023 - Individual Registration

First Name *

Last Name *

Organization

Address *

Address 2

City *

State *

Zip *

Phone

Email *

Your Pronouns

Age (if under 18)

T-shirts

Favorite Colors

Photo Release *

Yes I consent to use of my photo or image for Chalice Sparx advertising or social media

No I do not consent

Comment

Optional Donation

20

30

40

50

60

70

80

100

Meal Packages

Adults $70

Youth 13-18 $70

Children 4-12 $35

Children 3 and under FREE

I will Volunteer 2 hrs/day FREE

Lodging

Tent $100

RV $150 with electric hookup

Sycamore Lodge $250 (sleeps 6 per room)

Dietary concerns/restrictions

Omnivore

Vegetarian

Vegan

Gluten-Free

Allergies

Amount

$

Payment Method *

Offline Payment

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

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Individual Registration

Payment Information

July 7-9, 2023

REGISTER NOW!