Missions to Mexico
Group List/Children Ages 6-12
Name of Group: ____________________________


CHILDREN (6-12)                                        
1.                                                                 
2.                                                                 
3.                                                                
4.                                                                
5.                                                                
6.                                                                
7.                                                                
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.


TOTAL CHILDREN ____________ X $175 per child     $____________

                                                                     TOTAL    $____________

Please bring this form along with your Group Fees (Dollars) and deliver it to us in Mexico.  We will provide
you with a receipt upon receiving your funds. If bringing your Group Fees to Mexico in dollars presents a
hardship for you, let us know and we'll provide an alternative way to pay your group fees.