three60five 2020 Registration
Email address *
Attending As: *
First Name *
Your answer
Last Name *
Your answer
Gender *
Age *
Grade *
T-Shirt Size *
Address *
Your answer
City/Town *
Your answer
Province *
Your answer
Postal Code *
Your answer
Phone Number (include area code) *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
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Group you are coming with *
Your answer
Youth Pastor Email (not required)
Your answer
Roommate Preference (1 only, no guarantee)
Your answer
Health Card Number *
Your answer
List Allergies *
Your answer
Medical Concerns *
Your answer
Payment Option (Price INCLUDES GST) *
Payment Type *
Waiver *
LEGAL WAIVER: This waiver must be completed and signed by all registrants. You cannot attend the event if we do not have this form. Understanding that the faculty and staff of Nipawin Bible College will act according to their best judgment to ensure the health and safety of all participants, I hereby release Nipawin Bible College and all people associated with three60five 2020, from legal liability for any injuries or illnesses involving the registrants while at three60five 2020. I understand the registrant is expected to conduct him/ herself in a manner conducive for Christian fun and spiritual growth. I accept that the leadership of three60five 2020 reserves the right to correct and/ or send a registrant home at his/ her expense. I also understand that the registrant may show up in three60five 2020’s weekend media and future promotional material, and release to Nipawin Bible College the legal right to the usage of these images.
Signature (if you are 17 or under, a parent/guardian must sign) *
Your answer
A copy of your responses will be emailed to the address you provided.
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