Date: Saturday, June 29 - Sunday June 30

Time: 4:00 PM on Saturday - 1:00 PM on Sunday (After Block Party)

Location: Somahng Presbyterian Church

451 Grand Avenue Palisades Park, NJ 07024

Notice: Please bring bible, journal, sleeping bag, extra clothes, and toiletries

Student #1 Name

First Name

Last Name

Phone # / Parent Phone #

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Student #2 Name

First Name

Last Name

Student #3 Name

First Name

Last Name