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YRUUP Registration
Registration for Fall Con 2018!
Email address *
Basic Information
Answer all questions with honesty and maturity. Your answers are confidential.
Legal First Name (for filing purposes) *
Your answer
Legal Last Name *
Your answer
Preferred Name (if your legal name is the same, please skip.)
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Pronouns *
Required
Congregation *
If you do not attend church, please provide your city of residence in the "other" category.
Phone Number (best number at which to contact you) *
(123)456-7890
Your answer
Home Address *
#### Street, City
Your answer
Emergency Contact
If you have not arrived safely at any YRUUP event by the end of the orientation, and we have been unable to contact you personally, we will reach out to your emergency contact.
First Name *
Your answer
Last Name *
Your answer
Relation *
Mother, Father, Parental Guardian, etc.
Your answer
Phone Number *
(123)456-7890
Your answer
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