2019 Mission Evansville Adult Participant Registration (due April 12)
Must be filled out by all adult participants, 18 YEARS AND OLDER. Registration must be submitted by April 12, 2019.
Church Name *
Your answer
Group Leader *
Your answer
First Name *
Your answer
Last Name *
Your answer
Gender *
Age ON June 12, 2019 *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
What is your T-shirt size? *
(adult sizes)
Street Address *
Your answer
City, State, ZIP code *
Your answer
Primary Phone *
Your answer
Email *
Your answer
Emergency Contact *
Your answer
Emergency Phone *
Your answer
First Choice for worksite *
We cannot guarantee your work assignment, but we will do our best. What is your first choice?
Second Choice for worksite *
Please confirm which days you are available to chaperone. Check whichever days apply. *
Required
Do you have any other comments about your availability?
Your answer
Do you have any special skills in carpentry, electrical, painting, plumbing, etc? If so, please describe:
Your answer
Describe any other skills you have:
Your answer
Are there any health issues we need to know about before placing you at a worksite?
Your answer
Other interests:
Do you have any special dietary restrictions, requirements or food allergies that we should know about?
Your answer
RSVP: Family and friends are invited to join us for our closing celebration on Saturday, June 15 but we need a head count for food. What is the estimated number of family or friends who will join us for dinner at 4:30 pm?
Your answer
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