On-Line Pre-Registration


 
 


Thank you for your interest in participating in our programs to the orphaned children of Baja. We look forward to working with you to create the best service experience possible. Take some time to fill out the registration form and submit it on-line, or print it and mail it to Genesis' US office:

This information does not hold spaces on the program that you have chosen, but allows us to contact you and discuss the details of your participation. After this discussion, we will determine the costs and locations that will fit your needs. Since programs are filled on a first come, first served basis you will need to make a financial commitment to secure your dates upon your agreement to our policies, payments and group conduct (which will be available to you with the determination of your costs and locations). Early reservation is advised.  The more complete the contact information you send us, the better we can serve you.

Primary Contact Name:

Type: Group    Individual 

Email Address:

Website:
Daytime Phone: Night Phone:
Fax:       Alternate Phone:
When is the best time to reach you?
Address:

 

Church/Organization/Business (if applicable):
Person Leading Group (if applicable):
Position Title (if applicable):

If a group, how many attending (estimated):
Please break your expected group size down to the following categories (if possible)
If families wish to stay together, please submit the family name and number of persons separately. Any child under Junior High age will be the sole responsibility of the family members.

Married Couples?
Single Adults?     Males   Females
Senior High Students?      Males   Females
Junior High Students?       Males   Females

Ratio of leaders to participants?    :

What is the age range of group participants? to

Have you talked with one of our representatives? No   Yes

When would you like to go (subject to availability)?

Do you have a specific skill, expertise, or special interest that you would like to share?


How did you hear about Genesis?
Past-participant Friend  Colleague  Church   Presentation   Website  News Media    

Name of person/place from above?


I understand that I will be contacted either by phone, email, or through any method provided in this form in the order it has been received. This form does not hold spaces on the program that I have chosen. Early reservation is advised. Programs are filled on a first come, first served basis. I further understand that once I make a financial commitment, the following information will be made available to me: Legal forms, packing lists, itineraries, travel tips, transportation and accommodation arrangements. By submitting information, I understand the above statements.



Submitting this form via the internet (instead of mailing a copy) will reveal your email address to us. 

A non-refundable deposit is necessary in order to secure your dates.