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Filled by an officer: Form No: ________ Date of Registering ____________________

MASTER COPY

CIY MOVE 2013 REGISTRATION FORM BATAAN*


March 26-29, 2013 RMW Resort, Alasasin, Mariveles, Bataan
Im a
CIY:

From Bataan:

Outside Bataan:

__ Staff/Committee

__ COC Minister/Youth Minister

__ COC Minister/Youth Minister

__D-Group Leader

__ Youth Leader

__Youth Leader

__E-Group Leader

__Youth Member

__Youth Member

__visitor

__visitor

Full Name: _________________________________________________________ Gender: __ Male __ Female


Birthday: _______________________ Age: ____ Home Address: ____________________________________
________________________________________ Studying/Working at _______________________________
_______________________________________________________ Contact: ___________________________
Email: ______________________________ Church you are attending: ________________________________
For emergency purposes, notify __________________ Relationship: ___________ CP No: ________________

Filled by an officer: Form No: ________ Date of Registering ____________________

PARTICIPANT COPY

CIY MOVE 2013 REGISTRATION FORM BATAAN*


March 26-29, 2013 RMW Resort, Alasasin, Mariveles, Bataan
Im a
CIY:

From Bataan:

Outside Bataan:

__ Staff/Committee

__ COC Minister/Youth Minister

__ COC Minister/Youth Minister

__D-Group Leader

__ Youth Leader

__Youth Leader

__E-Group Leader

__Youth Member

__Youth Member

__visitor

__visitor

Full Name: _________________________________________________________ Gender: __ Male __ Female


Birthday: _______________________ Age: ____ Home Address: ____________________________________
________________________________________ Studying/Working at _______________________________
_______________________________________________________ Contact: ___________________________
Email: ______________________________ Church you are attending: ________________________________
For emergency purposes, notify __________________ Relationship: ___________ CP No: ________________

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