MUKEN Camp Registration Form
Surname (Family Name)
Your answer
Given Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Are you a Student at Monash University?
Student Number
Your answer
Student Email
Your answer
Are you an International Student?
Are you a Monash Residential Student?
Personal Email
Your answer
Contact phone number
Your answer
Any illnesses, conditions, or potential health-related limitations we should be aware of? (eg. Asthma, hearing problems, etc.)
Your answer
Any injuries (especially anything serious, chronic, or recurring)?
Your answer
Any allergies or dietary requirements?
Your answer
Emergency contact number
Your answer
Emergency contact name
Your answer
Relationship of emergency contact
Your answer
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