Waitlist Info Form - 2017 DiscipleMakers Women's Conference
Name: Last, First *
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Registration Type *
Email *
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Address Line 1 *
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Address Line 2
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City *
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US State/Canadian Province *
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Zip (Postal Code) *
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Phone Number *
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Food Allergies
DiscipleMakers is happy to provide special meals for you as long as you are happy to eat them! By writing your allergy/allergies in this box, you are agreeing to eat the special food purchased for you by DiscipleMakers. Sometimes this could mean a full meal, and other times this could mean special food to supplement the main meal provided by Doubling Gap. A letter will be included in your packet further explaining these details. As a reminder, do not write down food preferences.
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Any Other Special Needs
(allergies, dietary restrictions, disabilities, etc.)
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What school are you from? *
Graduation Year *
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Emergency Contact Name *
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Emergency Contact Phone Number *
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