September 13, 2018 ALVDC Communications Back to the Mountain On-Line Application BACK TO THE MOUNTAIN – 2019 REGISTRATION Friday November 15 – Sunday November 17 Back to the Mountain is event open to all followers of Christ. Please provide the following information: "Back to the Mountain - 2019" Application I am (first and last name) * I worship at (Name of Church) * I made (weekend and table, if applicable) * Email Address * Phone # * Gender * Male Female Street Address * City * State * Zip * Medically-necessary Dietary Requirements / Medical conditions we should know about. Allergies Room preference * Shared room - - roommate preference below Shared room - - no roommate preference Single room - If shared room, requested roommate (optional) Are stairs OK? Some rooms are on the second floor. * yes no I will pay * online mail a check If you are human, leave this field blank. Request to attend I would like to attend the upcoming Atlanta Lutheran Via de Cristo "Back to the Mountain" event.