MOUNTAIN JUSTICE SPRING BREAK

Fill out the form below to register for Mountain Justice Spring Break.

Suggested registration is $100 for the entire week, but we'll accept registration on a sliding scale from $50-500+. We will also provide a fee waiver to those truly in need.

Click "Donate / Pay" for more info.

Pay Now! you can also click on donate / pay button after you fill this form out or from the MJSB home page. Please pay using the same e-mail you used for registration, this way we can properly match your payment with your registration information.

Have questions? email . We look forward to hearing from you!

*First Name

*Last Name

*Email

*Phone

School / Organization

*Mailing Address

*City

*State

*Zip

*Emergency Contact Name & Phone

Where will you be coming from? (City & State)

Car Pool List - Checking this box adds yourself to a car-pool list including your first name and city of departure. Other registrants may then use a form on this site to send you an e-mail message. This message will be relayed from this site, so as to not disclose your e-mail and physical addresses.
include me

*Which week do you plan on coming?

If you are only coming for a few days, please specify which days you plan on coming.

*What do you want to get out of the trip? what do you have to bring to MJSB? feel free to include other thoughts or suggestions you have for the trip.

Do you require any special accommodations? (if yes, please explain)

Submit

Emory & Henry