Central Alabama Walk to Emmaus Application

Complete this form, submit and send a $25 reservation fee
The reservation fee of $25 is required for the application and is non-refundable and non-transferable
Make check payable to CAEC and mail to: 
Central Alabama Emmaus Community, P.O. Box 241571, Montgomery, AL 36124.
The total charge for the weekend is $135 fee. The balance of $110 will be due on the first night of the walk
on which you are scheduled to attend.
Any questions on the applications submitted, please email:lhhcaew20@gmail.com:
Any questions about the walks and schedules, please contact:
Registrar for Men’s Walks: Sharon Truman (334-354-4382), sharontruman520@gmail.com
Registrar for Women’s Walks: Lynn (MO) Moseley (334-749-6613), lynnmoseley7748@gmail.com


Questions prefixed with an * are required
1. APPLICANT INFORMATION: Please provide all requested information.
*First Name*Last Name
*Address(Name for your name tag):
*City
*State*Zip Code*AGE
Home PhoneWork PhoneCell Phone
Email Address
*2. Male or Female:
3.
*Spouse(or Emergency Contact) Name*Emergency Phone Number
4.
Occupation:Community Organization:
Home Church Name:Denomination:Pastors Name:
5. How long have you been involved in church?
6. The following has been explained to me: Emmaus Weekend
7. Reunion Groups:
8. If Married, has your spouse been on a Walk to Emmaus?
9. If so, Walk #
Walk #Location
10. Medical Information, required:
I am on a special diet?Yes
I have food allergies?Yes
I am taking Special Medications?Yes
I have physical limitations?Yes
I prefer a Lower Bunk?Yes
If Yes, please explain below:
11. I want to attend the Central Alabama Walk to Emmaus because:
12. I understand this signed application does not reserve a position on a particular walk, but does put me on the list for
upcoming Central Alabama Emmaus Walks.
*Applicant Signature (Type Name)Date
13. SPONSOR INFORMATION: Please provide all requested information.
Sponsor Name: FirstLast Name
Address
CityStateZip Code
Home PhoneCell Phone
Email Address
14. Sponsor's Church:
Your church name:Denomination:
15. Attent Church Regularly:
16. If no, please explain:
17. Where did you attend the Walk to Emmaus?
Location:Walk #:Are you in a reunion group? Yes\No
** 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.
18. 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!!!
Sponsor Signature:Date:

   

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