DisCon 2020 Registration Form for Rotaractors
Email address *
First Name
Your answer
Middle Name
Your answer
Last Name *
Your answer
Badge Name *
Your answer
Gender *
Phone Number *
Format: Numbers only. No spaces, letters or symbols. e.g: 254712345678
Your answer
Rotaractor or Guest? *
Rotaract Club of:
Your answer
Country of Residence *
Your answer
Special Diet Info: *
Your answer
Physical Disability Info: *
Your answer
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