Dual District Women’s Fellowship Day Trip Registration - Saturday, October 31st (7a.m. Departure - 9:00 p.m. Return)

Coach travel to Sarasota, FL to Ellenton Premium Shopping Outlet

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1. What is your full name?

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2. Which district do you belong to?

Palatka

Gainesville

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3. What is your preferred method of contact?

Phone

Email

Text message

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4. Please provide your preferred contact information below.

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5. I have paid the $50 fee to my respective district.

No

Yes

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6. I will be paying the $50 fee on or before October 11th to my respective district to confirm my seat. (When paying to your District, be sure to include “Dual District Women’s Trip” on your envelope or in the comment section when giving electronically).

Yes

No