Registration - Everfresh XIV
Email address *
Name *
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Surname *
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Age *
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Gender *
Physical Address *
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Cell Phone Number *
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Home Number
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Allergies / Medical Needs
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Do you attend The People's Church *
If yes, which campus do you attend?
What School do you attend? *
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Full Names of Parent / Guardian *
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ID Number of Parent / Guardian *
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Contact Number of Parent / Guardian *
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Email of Parent / Guardian *
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By clicking agree (below), you hereby indemnify, hold blameless and acknowledge that neither you nor the above mentioned person names has/have any action or claim against The People's Church AOG in South Africa or any of its appointed workers; you certify by checking the agree box that you are authorised to represent, act for or otherwise contract for the above mentioned minor/youth who similarly indemnify, hold blameless and acknowledge that they have no action or claim as hereinbefore set forth. You acknowledge that everyone is participating at their own risk
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