Pine Valley Bible Conference Center (map) 8668 Pine Creek Road Pine Valley, CA, 91962 United States ✚ gCal ✚ iCal Registration has been extended through 1/31/2020! REGISTRATION PACKET MEDICATION AND INHALER FORM STAFF REGISTRATION FORM Midwinter Staff Registration *This registration form is for midwinter staff only* Midwinter 2020 is from February 14-17 at Pine Valley. Payment must be sent in separately. For questions, please contact your director. Training Sessions: January 18, 2020 from 9:30am - 12:30pm at Venice; February 1, 2020 from 9:30am - 12:30pm at Mission Valley. Name * First Name Last Name Email Address * Phone * (###) ### #### What is the best way to reach you? * Email Phone Address * Please enter your full address Address 1 Address 2 City State/Province Zip/Postal Code Country Church * T-shirt size How are you actively growing in your faith/relationship with God? * How have you seen God work in your life recently? * List food allergies, if any: * List medications you are bringing, if any: * Consent to background check * Do you give your consent to a background check in the event one has not been done in the last three years? Yes No Upon completing this form, please make payment of $175 to PCJC. There is a $50 fee for any cancellations. There are no cancellation refunds after December 31. Thank you for registering for Midwinter 2020!
