Chapel Picture

Scottlea Gospel Chapel

500 Scott Street St. Catharines, Ontario, Canada
905-646-0761 scottleagc@yahoo.ca
An Assembly of Christians Gathered
unto the Name of the Lord Jesus Christ
Home ---> Youth Conference 2012

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After February 15 2012, the cost to attend the
conference will be $20 CAD, payable on Friday night at Registration.
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* Select Gender: Male Female
* First Name:
* Last Name:
* Address:
* City:
* Province/State:
* Postal/Zip Code:
* Phone Number w/ Area Code:
Allergies (Pet or Food. Separate w/ comma):
* Ontario Health# or U.S. Insurance CO. Policy#
Select which days you'll attend Friday
Saturday
Sunday
* Do you need accommodations? Yes No
Name of friends you would like to stay with
(separate names with commas)
* Name of Emergency Contact:
* Emergency Contact Phone #:
* Email Address:
YC 2012
YC 2012