Camp Online Registration

Aum!

< Online Registration > -The one Last Formal Step before the Ultimate Experience.. (A small deposit fee of $15/pax would be required. This would be refunded back on the last day of the camp. Details of payment would be made available after registration). (Fields marked with an * must be filled)*
Your Name (as in NRIC): *
NRIC Number: *
Nationality: *
Preferred T-Shirt Size: *
Residential Address: *
E-mail Address: *
Handphone Number: *
Handphone Model Name: *
Date of Birth (DD/MM/YY) *
Diet: *	Vegetarian Non-Vegetarian

We wanna know More About You..
Employer/Name of School: *
Occupation:
Name of Organization Represented (if any):
Position Held (if any):
Hobbies & Interests:

Emergency Contact Information
Name of Person to Contact: *
Relation: *
Address: *
Handphone No: *
Home No: *
Office No: *
List any Special Medical Conditions you may have (if any):

How did you hear about this Camp?

Declaration And Indemnity *
*All participants of Youth '4' Youth III, 3Day-2Night residential camp and parents/guardians of participants under the age of 21, agree to the following.* By clicking on the "Submit" button below, I certify that all the information provided by me/ the participant in this registration form is true and correct. I agree that I will not hold the Youth '4' Youth III, 3D-2N residential camp Organizing Committee and their working partners liable for any injury, loss or damage that I/the participant may suffer or sustain in the course of or in connection with my/his/her participation.
I agree to the terms & conditions as stated above (You need to check this to proceed)*

Technical Problems on Website
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feel free to contact

nushindusociety@gmail.com