Registration Form

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REGISTRATION FORM

RECENT
PHOTO

Affix your recent PHOTO


NAME ...................... AGE ............
FATHERS NAME .....................
MOTHERS NAME ......................
ADDRESS ..................
..............
MOBILE NO. (Yours) ........ (Parents) ...............
CHURCH NAME ...
PASTORS NAME ....................
PASTORS NO. ..
1. Why do you want to attend this camp? Explain in no less than 50 words.

2. The camp will be focusing on A life style of excellence and Handling interpersonal
Relationships. How do you think or expect this camp to help you in your own life?

NOTE Kindly fill all the parameters above and submit this form to the person you got it
from or call any of the three numbers given on the post.
PARENTAL CONSENT
I Mr./Mrs.............. agree to send my child
............... to this camp by my free will and permission.


Signature_________________________

Father / Mother (Date..)

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