Name of Congregation Phone Address City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip Group Leader Name Cell Phone Email Number of Attendees Youth Boys Youth Girls Adults Numbers by Grade: 6th 7th 8th 9th 10th 11th 12th Total Attending: Will your group attend Friday evening? Yes No Will your group request housing with the Mountain Home congregation? Yes No Additional Housing Info List Female Adult Names List Male Adult Names List Couple Names Check if one adult chaperone per house is needed. Youth should bring a sleeping bag and pillow.Housing is limited and will be on a first come basis. Housing requests need to be made by June 30. Which nights will you be staying? Friday Saturday Both Will your group attend the Sunday AM service? Yes No T-Shirt Sizes Small Medium Large X-large XX-Large XXX-Large The cost for Christ Quest is $10 per student. Two Chaperones will be free. At this time, please plan to cover all your groups meals. Registration will begin at 6:45 Friday evening and Saturday at 9:00am.
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