CrossWire

Liability Form

Please take the following steps to register for CrossWire:

Date of trip is Thursday October 27, 2005 to Sunday October 30, 2005

bulletFor information on this trip e-mail Brianna at brianna@clubdust.org
bulletType  in information and print out this form.
bulletPrint out form" Liability form" sign and date                   
bulletSend check (payable to "Laura Campbell"), Registration Form,  and Liability Form to address below
bulletFor families, please fill out a separate registration form for each person. 

**Refund Policy - Due to the cost of the trip and deposits that are required months before the trip we cannot refund your registration fee's if you signup and are not able to go on the trip.

Attn:  CrossWire

C/O  Laura Campbell

1209 San Andreas Rd

Watsonville CA 95076

 Please provide the following information:

First name
Last name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Work Phone
Home Phone
Cell  Phone
E-mail

 

bullet

How did you hear about Crosswire?
    

CrossWire Trip

This fee applies if you self- raise money equal to or more then 300 dollars

 Cost of Trip

$300

 t-shirt size

sizes S M L XL XXL
CrossWire Trip

This fee applies if you DO NOT fundraise       

Cost of Trip

$400

 t-shirt size

sizes S M L XL XXL

Emergency contact in the U.S.
Name
Address
City, State, zip code
Phone number

Enter today's date:

-- mm/dd/yy

Please don't forget to send in Liability form and buy your tickets early!

Trip begins at San Diego Airport at 8:00 PM Thursday October 27, 2005.  We will meet at Terminal 2 by American Airlines.  Look for Brianna with red and yellow balloons. Trip ends Sunday October 30, 2005. Plan to arrive back to the San Diego Airport by 11 AM, so book your flights between 12 PM to 3PM.  

Crosswire does not provide any medical coverage.  You can buy short term insurance, if you would like more information please contact the following companies:

Insurance Services of America is a Christian Organization dedicated to assisting missionaries, church teams and mission organizations,

 who travel or live overseas, find affordable international health, life and travel insurance.       http://www.missionaryhealth.com/

STM  Services International:  They provide short term missionary coverage. Please see their web site:    http://www.stmservices.com

Rancho La Paloma (lodging in Mexico during CrossWire trips)

Club Dust participants can be reached at the number below in case of an emergency, in the evenings and morning hours.  Please give this number to your family. Care takers of the ranch are Mari and Nemo 01152-665-654-232

Last revised: October 07, 2005

Liability FormClub Dust

Send mail to alicia@clubdust.org  with questions or comments about this web site.
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Last modified: August 06, 2007