Facilitator Registration Form  

First Name Last Name Nickname

Gender: ___ Male ___ Female

Birthday (example: Jan 1, 2000): ___________________________

Which city do you live in? ___________________________

Mobile Number: ___________________________ Email: ___________________________

Dgroup Leader’s Full Name: _____________________________

Dgroup Leader’s Contact No: _____________________________

Emergency Contact Person’s Name: _____________________________

Emergency Contact Person’s Contact No: _____________________________

Do you attend CCF on Sundays? ___ Yes ____ No

Have you attended a True Life Retreat before?

___ Yes, which one/s? ______________________________

___ No

Have you facilitated in a True Life Retreat before?

___ Yes, which one/s? ______________________________

___ No

Which age range are you most comfortable handling? Rank the following age ranges with
4 as your most preferred age range and 1 as your least preferred.

13-15 16-18 19-21 22-24

Are you willing to volunteer in Elevate North EDSA every Saturday after the camp?
(Elevate is every Saturday, 3PM-6PM)

___ Yes

___ No
 Facilitator Registration Form  

First Name Last Name Nickname

Gender: ___ Male ___ Female

Birthday (example: Jan 1, 2000): ___________________________

Which city do you live in? ___________________________

Mobile Number: ___________________________ Email: ___________________________

Dgroup Leader’s Full Name: _____________________________

Dgroup Leader’s Contact No: _____________________________

Emergency Contact Person’s Name: _____________________________

Emergency Contact Person’s Contact No: _____________________________

Do you attend CCF on Sundays? ___ Yes ____ No

Have you attended a True Life Retreat before?

___ Yes, which one/s? ______________________________

___ No

Have you facilitated in a True Life Retreat before?

___ Yes, which one/s? ______________________________

___ No

Which age range are you most comfortable handling? Rank the following age ranges with
4 as your most preferred age range and 1 as your least preferred.

13-15 16-18 19-21 22-24

Are you willing to volunteer in Elevate North EDSA every Saturday after the camp?
(Elevate is every Saturday, 3PM-6PM)

___ Yes

___ No
Please choose a shirt size by placing a check mark beneath your shirt size:
*Shirts are not included in the P3,500 registration fee

18 20 XS S M L XL XXL

Waiver:

While the organizers shall endeavor to take care of the needs and look after the welfare of the WILDFIRE
True Life Retreat attendees and facilitators, the facilitator acknowledges that he or she is attending the
retreat and will be participating in activities at their own risk. The attendee assumes full responsibility for
any personal injuries, loss of property, and damages of whatever nature sustained for the duration of the
retreat, including travel to and from the venue. The attendee shall not hold the organizers liable and fully
and forever releases and discharges the organizers from any and all claims, demands, rights of action, or
causes of action that may accrue to the participant on account of this retreat.

By signing below, I understand and accept all the terms mentioned above.

Facilitator
PRINTED NAME & SIGNATURE

----------------------------------------------------------------------

For Wildfire Workers to fill out Date: ___________________

___ Received Dgroup Endorsement Form

___ Paid; Receipt No: ___________________________________

___ Installments

PAYMENT SCHEME: How many installments? _______

Date: Amount: Receipt No:

___ Will pay another time Received By: ________________________

NAME & SIGNATURE
Please choose a shirt size by placing a check mark beneath your shirt size:
*Shirts are not included in the P3,500 registration fee

18 20 XS S M L XL XXL

Waiver:

While the organizers shall endeavor to take care of the needs and look after the welfare of the WILDFIRE
True Life Retreat attendees and facilitators, the facilitator acknowledges that he or she is attending the
retreat and will be participating in activities at their own risk. The attendee assumes full responsibility for
any personal injuries, loss of property, and damages of whatever nature sustained for the duration of the
retreat, including travel to and from the venue. The attendee shall not hold the organizers liable and fully
and forever releases and discharges the organizers from any and all claims, demands, rights of action, or
causes of action that may accrue to the participant on account of this retreat.

By signing below, I understand and accept all the terms mentioned above.

Facilitator
PRINTED NAME & SIGNATURE

----------------------------------------------------------------------

For Wildfire Workers to fill out Date: ___________________

___ Received Dgroup Endorsement Form

___ Paid; Receipt No: ___________________________________

___ Installments

PAYMENT SCHEME: How many installments? _______

Date: Amount: Receipt No:

___ Will pay another time Received By: ________________________

NAME & SIGNATURE