Faith Christian Church World Outreach of Fredericksburg VA

SUMMER XPLOSION 2008 REGISTRATION

Please fill out the form below :
Name *	:
Gender	:
Date of Birth/Age
Email/Myspace	:
Phone Number	:
Street Address	:
City	:
State	:
Zip	:
Are you participating in the 3 on 3 B-Ball Tournament? (You may be asked to verify your age)	:	Yes No
How did you hear about this event?
Advance registration ends Monday August 18th Registration includes concert and all youth events and a chance to win the GXP Grand Prize. Advance registration: $10.00 Door registration: $15.00 Send registration and fee to : Faith Christian Center 10606 Benchmark Road Fredericksburg, VA 22408