| Church Name | Revive Wesleyan |
| Church Email | info@revivewesleyan.com |
| Church Phone | (716) 649-6335 |
| Church Street Address | 4999 McKinley Parkway |
| City | Hamburg |
| State/Province | NY |
| Zip/Postal Code | 14075 |
| Notes regarding the church address provided | CSB Unit meets at the South Creek campus location. |
| Chairman FIRST Name | Scott |
| Chairman LAST Name | Haima |
| Chairman Email | shaima@csbministries.org |
| Chairman Phone | 7168126755 |
| Chairman Street Address | 5934 Rice Road |
| City | Boston |
| State/Province | NY |
| Zip/Postal Code | 14025 |
| Notes regarding the chairman info provided | |
| We'll be running these programs | Stockade, Battalion, Tree Climbers |
| Total # boys/girls anticipated to participate | 30 |
| We Agree to the responsibilities included in the Working Agreement | 1 |
| Region | Northern California |
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