Application for Central Alabama Walk to Emmaus

Application for Central Alabama Walk to Emmaus
$150 fee is charged for the weekend. Complete this form, Submit, including sending a $25 reservation fee, non-refundable and non-transferable, (make check payable to CAEC) and mail to: CAEC, P.O. Box 241571, Montgomery, AL 36124. The balance of $125 will be due on the first night of the walk on which you are scheduled to attend. Any questions, call or e-mail: Registrar for Men’s Walks: Sharon Truman (334-354-4382), sharontruman520@gmail.com. Registrar for Women’s Walks: Lynn (MO) Moseley (334-221-4991), lynnmoseley7748@gmail.com
Name *

First Name Last Name
Name for Name Tag:
Address *

Street Address

Street Address Line 2

City State

Zip Code
Age *
Male or Female:

Male Female
E-mail
Please provide if you have an e-mail.
Home Phone Number *
Cell Phone Number
Spouse or Emergency Contact *
Required
Emergency Phone Number *
Occupation
Occupation
Are you a Minister or Pastor?.

Yes No
Ministerial Title
Serving what church or retired?
Home Church Name
Pastor's Name:
Denomination
If Married, Has Spouse been on Walk to Emmaus

Yes No
If so, Walk # and Location
Type Walk # and Location (i.e. #193, Camp Alamisco)
I am on MEDICALLY SPECIFIED Diet?

No Yes
I have food allergies?

No Yes
I am taking special medications?

No Yes
I have Physical Limitations?

No Yes
I prefer a Lower Bunk?

No Yes
If yes, answered above, please explain "Yes" answers:
I want to attend the Central Alabama Walk to Emmaus because:
I understand this signed application does not reserve a position on a particular walk, but does put me on a list for upcoming Central Alabama Emmaus Walks .
Please sign\type name here.
Date Signed by Applicant

Month Day Year
Please select date.
SPONSOR'S NAME *

First Name Last Name
SPONSOR's ADDRESS *

Street Address

Street Address Line 2

City State

Zip Code
SPONSOR's E-MAIL: *
example@example.com
Sponsor's Home Phone Number *
Sponsor's Cell Number
Sponsor's Home Church
Denomination
Attend Church Regularly:

Yes No
If No, please explain
When and where did you Attend Walk to Emmaus?
Walk # and Where?
Notice:

By signing this below, I agree that I understand and will assume responsibilities of a sponsor and fully believe that my applicant is ready for his\her Walk to Emmaus! ** There are no Handicap Accessibility features of the Facility Rented By C.A.E.W. for the 72 Hour Emmaus Walk. Applicants must be physically able to go up and down stairs, walk between the large Gathering Room and Individual Rooms and Restroom Facilities without assistance during the 72 Hours of the Walk. *** I am acknowledging that I am aware there are no Handicap Accessibility Features at the Camp. Revised 1/21/2019.
Sponsor Signature:
Sponsor's Sign Agreement to notice
Date

Month Day Year
Date
Should be Empty:

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Application for Central Alabama Walk to Emmaus

Notice: