| Church Name | Revive Wesleyan |
| Church Street Address | 4999 McKinley Parkway |
| City | Hamburg |
| State/Province | NY |
| Zip/Postal Code | 14075 |
| Notes regarding the church address provided | |
| Chairman FIRST Name | Scott |
| Chairman LAST Name | Haima |
| Chairman Street Address | 4366 Beach Avenue |
| City | Hamburg |
| State/Province | NY |
| Zip/Postal Code | 14075 |
| Notes regarding the chairman info provided | |
| We'll be running these programs | Tree Climbers, Stockade, Battalion |
| Total # boys anticipated to participate | 41-45 |
| The "Working Agreement" identifies our mutual responsibilities and can be viewed here: csbministries.org/workingagreement | We Agree to the responsibilities included in the working agreement |
| Region | |
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