REGISTRATION FORM

  • Participant Contact Information
  • Sibling Information

  • Parent / Guardian Contact Information

  • CONSENT TO PHOTOGRAPHS/VIDEOS/YOUTUBE RELEASE & EMERGENCY MEDICAL CARE

    I authorize World Youth Foundation, Inc., to use any appropriate photographs, videos, YouTube while my child is participating in the 2014-2015 session. Those items are approved to promote and share the story of the program. For emergency care, contact the individual listed below, facility and/or doctor. Further consent to the provision of medical care by the facility listed below and/or doctor, if such is necessary in a medical emergency or to prevent death.
  • Medical facility to provide medical care in case of an emergency: