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Get and Sign Concho Contry Emmaus Pilgram Application Form
LISTED” UNTIL FEE HAS BEEN PAID IN FULL. PLEASE CHECK WITH LOCAL FOURTH DAY GROUP FOR
SCHOLARSHIP ASSISTANCE AND INFORMATION.
WALK#________ Date_________ Cost________ Location_________________________
*If you are put on the wait list, can you attend on short notice? 1
1 Week 2
3 – 4 Days 3
Less than 3 days*
Last Name:_________________________ First Name:________________________ Name Tag:__________________
2 Male
2 Female
Date of Birth:_____________
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