2015 Northwestern Minnesota Synod Middle School Gathering
Sanford Center, Bemidji
Session 1: November 20-21, Conferences 1 – 5
Session 2: November 21-22, Conferences 6 – 10
Early Bird Registration - $75/participant – Deadline October 28
Registration after October 28 - $90/participant – Deadline November 16
Please complete this fillable form on your computer, print, calculate your payment and send to the
Northwestern Minnesota Synod, Concordia College, Moorhead MN 56562.
Congregation/Parish: Click here to enter text.
City: Click here to enter text.
Adult Leader (contact person) who will be attending the gathering: Click here to enter text.
Cell phone: Click here to enter text.
Email: Click here to enter text.
Participant Name
Shirt Size (Adult)
Dietary or Accessibility Needs
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Registration Fee
1.
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☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
☐ $75.00 Early Bird
☐ $90.00
2.
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☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
3.
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☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
4.
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☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
5.
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☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
EARLY BIRD number of participants (include numbers from all pages) Click here to enter text. x $75.00 = Click here to enter text.
AFTER October 28 number of participants (include numbers from all pages) Click here to enter text. x $90.00 = Click here to enter text.
Participant Name
Shirt Size (Adult)
Dietary or Accessibility Needs
Click here to enter text.
Registration Fee
6.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
☐ $75.00 Early Bird
☐ $90.00
7.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
8.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
9.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
10.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
11.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
12.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
13.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
14.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
15.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
16.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
Participant Name
Shirt Size (Adult)
Dietary or Accessibility Needs
Click here to enter text.
Registration Fee
17.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
☐ $75.00 Early Bird
☐ $90.00
18.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
19.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
20.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
21.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
22.
Click here to enter text.
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
23.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
24.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
25.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
26.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00
27.
Click here to enter text.
☐ Adult Leader
☐ Wheaty
☐ Youth
☐Male
☐Female
☐S ☐M ☐L
☐XL ☐1X ☐2X
Click here to enter text.
☐ $75.00 Early Bird
☐ $90.00