The Circle Journey Group Registration

Church or Group Name

Group Leader Phone

(###)

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Group Leader Email

Church or group leader address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Emergency Contact

Position / Relation with Church or Group

Phone

(###)

###

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We are attending (choose one)

Leg A

Leg B

Bonus Leg C

Christmas Leg

We agree to enter into this Journey with an open mind and willingness to learn in all circumstances. We will read the “To Bring, Not to Bring list (will be emailed as a pdf attachment once your registration is submitted). We agree to participate in all learning and group activities as given to us by the 121 leadership. We understand that if a team member refuses, complains, or exhibits a negative attitude at any time that this will result in their being sent home at your group/church/their expense.

YES––Checking this box constitutes the group leader's agreement and signature.

Group Liability Form

In Consideration of attending any 121 inc. tour and or event I hereby affirm that my church/group and I agree to hold 121 inc. harmless from any and all claims, liabilities, losses, demands, causes of action, suits and expenses (including attorney fees), which may directly or in directly be connected to 121 inc. and/or my presence on 121 inc. tours and/or events, specifically related to but not limited to operation of 121 inc. production equipment and 121 inc. transportation. My church/group further agrees to indemnify any party indicated above should such party suffer any claims, liabilities, losses, demands, causes of action, suits and expenses (including attorney fees), caused directly or indirectly by my church/group’s negligent or intentional acts, or failure to act, or if such acts or failures to act are directly or indirectly caused by any person in my church/group or associates while participating in a 121 inc. tour and/or event. My signature upon this form also indicates agreement and acceptance on behalf of all minor children (under 18 years of age) under my care in attendance. 121 inc. only recognizes those who have registered with 121 inc. and have a signed Liability Release Form on File as participants of a 121 inc. tour and/or event. I have read this form on behalf of my group/church and fully understand that by signing this form I am giving up legal rights and/or remedies that may otherwise be available to me on behalf of my group/ church.

Signature

Yes I Agree––Clicking this box constitutes my signature and confirms my authority to sign for my church or group.

Signer's Full Name

Signer's position // Title

Today's Date

YYYY

Final Details

You will receive a confirmation email containing a "To Bring Not To Bring" list for you and your team. Read over it carefully. Please submit your group deposit and balances via check to 121 inc. These can be mailed to 121 inc. PO. Box 26 Wallburg NC 27373 -- or delivered to the 121 office. (contact us through the contact link in this site for our physical address. (2025 Summer legs $550 per person) Non-refundable deposit due May 1––($100––Leg A & B) *per person $100 x number of team members =_______ Balance due May 20 (leg A)––June 16 (leg B)––($450) *per person $450 x number of team members =_______ (Christmas Leg 2025) **$100 deposit due 11/30 *per person $100 x number of team members =_______ **$350 balance due 12/15 *per person $350 x number of team members =_______ We will ask you for a spread sheet containing all team member's full names, ages, genders, and cell numbers. Please remind all team members to fill out the individual registration form located on this site. (They will identify themselves with your church or group there.