Monitor Jr.

* Indicates required field

Name *

First

Last

Age *

Date of Birth 00/00/00 *

Gender *

Male Female

Registrant's Email (if applicable) *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Emergency Contact *

Emergency Phone # *

Your Church's Name *

Church location (city, state) *

Your Pastor's Name *

NOTE: Your pastor's signature is still required on the printed form for monitors. Please make sure you print the form provided on this site, have your pastor sign, and bring to registration.

Have you received the gift of the Holy Ghost? *

yes no

Have you been baptized in Jesus' Name? *

yes no

Have you been convicted of a crime involving inappropriate behavior with children? *

yes no

If answered yes to above, please explain. *

Payment Options *

PayPal

PayPal email address: *

Name of person or business paying via PayPal *

Submit

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We are the Apostolic Crusaders of Louisiana.
ACOFLA is a state-wide youth division of the Assemblies of the Lord Jesus Christ.
Terry Glaspell, President of Apostolic Crusaders of Louisiana
OLLA CAMPGROUND PHYSICAL ADDRESS: 1745 Loop Rd. Olla, LA 71465

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