East Texas Vida Nueva Application
After completing the registration form please print and sign or have your parent or guardian sign if under 18. It will also be emailed to you.
Please print and complete the medical authorization form. Link for the medical authorization form https://drive.google.com/file/d/15sqxDjjYnNDAWDJ8wx1KafyY3ChlqhhP/view?usp=sharing     
If you are under the age of 18 have parent or guardian complete and get notarized. If 18 or older please complete the bottom portion of the medical authorization form.
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Email *
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Name *
Street Address *
City *
State *
Zip Code *
Phone Number *
Date of Birth *
MM
/
DD
/
YYYY
Sex *
T-Shirt Size *
School Grade or College Year *
Church *
Parent / Guardian Name (if applicant / candidate is under age 18) *
Medical Special Needs *
Required
If yes please explain
Dietary Special Needs (i.e. vegetarian, no pork, etc) *
Applicant/Candidate: On the lines below, please include a statement about your walk with Jesus, what you need to help you with your spiritual growth, and what you hope to get out of this weekend. Please take time to carefully think this out. Knowing your needs will help us prepare for the weekend. *
Sponsor Information
Sponsor Name *
Weekend Attended *
Phone *
E-Mail *
Applicant / Candidate / Parent / Guardian Signature
For questions or updates email etvidanueva@gmail.com
I Understand that Water’s Edge Encampment (WEE) or Vida Nueva is not responsible for articles that are lost or stolen while the
participant named above (the “Participant”) is on WEE grounds. I understand that while the participant is at WEE that he / she
may be responsible for damage done to Camp or personal property.
A copy of your responses will be emailed to the address you provided.
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