Tell us about yourself ...

Please answer the following questions so we can begin to get to know you
before you come to your L.O.G. weekend

               
First Name
Last Name
Name for your nametag
     
Phone number
email address    
L.O.G. you wish to atttend
     
Who invited you to L.O.G.?
      
               

What color/s best describe the kind of person you are?

    
 

What musical instrument/s do you play?

    
 
In what extra-curricular activities do you participate?    
 
What are some of your hobbies?    
 
What two or three things are really important to you?    
 
What is one of your favorite snack foods?    
 
Do you have any special dietary needs?    
 
Give us 5-10 words that describe you    
 
What 2-3 emotions are most prevalent in your life these days?    
 
How do you feel about coming to L.O.G?
 

What else should we know about you?
 
               

AND please be sure you mail in the following as soon as possible. Thanks!

  1. Medical Release / Parent Permission Form
  2. check made out to Michiana Youth Ministries (or it can be paid via PayPal - click "Make A Donation" on the front page of the website and noye it is a LOG registration fee)
  3. a recent photo of yourself! (you can email it to: info@michianayouth.org)

Address: Michiana Youth Ministries, 52726 W. Cypress Circle, South Bend, IN 46637