travel form Your Name * First Name Last Name Birth date * MM DD YYYY Guest 1 * First Name Last Name Birth date * MM DD YYYY Primary Email * Primary Phone * (###) ### #### what dates work best for you? * July 11 - July 13 July 18 - July 20 Unfortunately, neither of the dates work best. Your nearest commercial airport * By entering the Florida Vacation Giveaway and submitting this form, I understand that there may be photos & videos taken while participating or being in close proximity to John Wesley and Reach City. I permit any image of the Participant, or Parent/Guardian, to appear in any electronic images or videos on social media platforms (i.e. Instagram, Facebook, etc.) or other electronic media and for the sharing of such images without compensation to either the Participant or the Parent/Guardian. I understand that this prize and all arrangements made cannot be exchanged for cash value.
