Niagara Mohawk District
How many will be attending:
Names of youth attending (Enter name on each line):
Name of leaders attending (Enter name on each line):
Church Name:
Address of Church:
City:
State:
Zip:
Email Address:
Phone number:
Pastor's name (if applicable)
Youth Pastor's name (if applicable)
How many rooms will you need? 1
2
3
4
5
More - Please call
Please check (for hotel) $22.50 ea. (4 people/room)
$30.00 ea. (3 people/room)
$44.50 ea. (2 people/room)
$89.00 ea. (single person)
Not staying at hotel
Please write us any speacial information or any other configuration of rooms:
Registration for each person (includes food) $32.75 ea. (with hotel)
$40.00 ea. (without hotel)
Are you paying online? Yes
No
Sending a check

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Downloadable PDF Files for the event
Next Level Flyer

Next Level Poster
Any questions please email:

Joe & Peggy Sessa
or
Mark Fedele
Please send checks payable to IFCA NIMO to:

Joseph Sessa
215 Sunshine Dr.
Amherst NY 14228