Tuesday, 19th February 2019
Registration Form
To register for our coming camp, simply fill in the form below and we will revert to you.
Name*
:
Address*
:
Gender*
:
Male
Female
Mobile Number*
:
Email*
:
Confirm Email*
:
Assembly/Church*
:
Preferred Roommate (One only)
:
Allergies*
:
Yes
No
If yes, please specify
:
Can you help in this area:-
Playing Piano
Playing Guitar
Song Leading
None of the above
Emergency Contacts
Emergency Contact Name*
:
Emergency Contact Number*
:
If you have any questions, contact one of our
Region Representatives
.
Connect.com.my
