XA Stand Alone Registration

XA Stand Alone Event

Come join us at The Assembly at Warner Robins for a one-day Chi Alpha event. There will be food, worship, community, games, and a chance to connect with other Chi Alpha students across the state. We hope to see you there!
Full Name *

First Name Last Name
E-mail *
Phone Number *

Area Code Phone Number
Your Campus *
Your University
I am *

Male Female
I am *

A Student Chi Alpha Staff Volunteer or Other
Payment Options - (entire payment must be received for you to be registered. All payments are non-refundable.) *

Paypal or Credit Card My Campus Pastor is making a group payment.
Payment:
prev next ( X )
REGISTRATION PAYMENT $ 9.99

Quantity
We will have a food truck, True Blue BBQ, come during our lunch hour! Due to our smaller numbers, we need a head count of what everyone would like ahead of the event. (Lunch is NOT covered by the registration fee.) Please choose which lunch option you would like: *

Pulled pork sandwich Chicken Quarters (thigh) Burger (beef)
Any Food Allergies or Medical Conditions we need to know about? Any other registration comments?
(ex. Payment notes, allergies, etc.)
Hit Submit button to register. If you are paying with Paypal, you will be taken to the Paypal site. All payments are non-refundable.
Should be Empty:

XA Stand Alone Event