REGISTRATION FORM - Quito, Ecuador
No Compromise International
Quito, Ecuador Trip June 15-22, 2019
INDIVIDUAL REGISTRATION FORM Deadline to Register: February 1, 2019
Instructions: Each Attendee must fill out this form and return it (with Deposit) to the address provided.
Student / Adult’s Name
Age
Male
Female (circle)
Mailing Address City
State
Home Phone
Zip
Last Grade Completed
Cell Phone
E-Mail
Date of Birth
Your Church Name
Pastor
In case of Emergency, Contact:
Their Phone
Your Medical Conditions: Indicate Roommate Preference:
COST:
$200.00 $1,550.00
Non-Refundable Deposit (Due February 1, 2019) Balance (Due April 1, 2019)
$1,750.00
Total Cost Per Person
INCLUDES: Flight, Lodging, Meals, T-Shirt, Transportation, & Insurance.
Participant Agreement (To be signed by all Attendees – Students and Adults) I understand that I am solely responsible for my conduct, safety, and well-being. I understand that the responsibilities of the staff and leadership of No Compromise International are only to provide guidance for this event. I fully understand that I am financially responsible for any damages that I may cause. I have read and understand the rules, and agree to abide by them. I also understand that failure to do so will result in our termination from this event, with no refunds being made.
Signature of Attendee Signature of Parent/Guardian Today’s Date
MAKE CHECKS PAYABLE TO: No Compromise International FOR MORE INFORMATION, CALL: 205.310.8067 (Rob Cain) www.NoCompInternational.com
SEND COMPLETED FORMS TO: NCI – c/o Rob Cain 1145 Brookhill Road Tuscaloosa, AL 35404 E-Mail: [email protected]
Quito, Ecuador Trip June 15-22, 2019
INDIVIDUAL REGISTRATION FORM Deadline to Register: February 1, 2019
Instructions: Each Attendee must fill out this form and return it (with Deposit) to the address provided.
Student / Adult’s Name
Age
Male
Female (circle)
Mailing Address City
State
Home Phone
Zip
Last Grade Completed
Cell Phone
Date of Birth
Your Church Name
Pastor
In case of Emergency, Contact:
Their Phone
Your Medical Conditions: Indicate Roommate Preference:
COST:
$200.00 $1,550.00
Non-Refundable Deposit (Due February 1, 2019) Balance (Due April 1, 2019)
$1,750.00
Total Cost Per Person
INCLUDES: Flight, Lodging, Meals, T-Shirt, Transportation, & Insurance.
Participant Agreement (To be signed by all Attendees – Students and Adults) I understand that I am solely responsible for my conduct, safety, and well-being. I understand that the responsibilities of the staff and leadership of No Compromise International are only to provide guidance for this event. I fully understand that I am financially responsible for any damages that I may cause. I have read and understand the rules, and agree to abide by them. I also understand that failure to do so will result in our termination from this event, with no refunds being made.
Signature of Attendee Signature of Parent/Guardian Today’s Date
MAKE CHECKS PAYABLE TO: No Compromise International FOR MORE INFORMATION, CALL: 205.310.8067 (Rob Cain) www.NoCompInternational.com
SEND COMPLETED FORMS TO: NCI – c/o Rob Cain 1145 Brookhill Road Tuscaloosa, AL 35404 E-Mail: [email protected]
