CFCYOUTHFORCHRIST

INFORMATIONSHEET

Cluster/Chapter/Area: North A: ___________________________

Youth Camp Date: ___________________

I. General Information

Name:_______________________________________________________________________
(Surname) (Given name) (M.I.)

Nickname______________

Address:_____________________________________________________________________

Home no.:_____________________E‐mail:_________________________________________

Mobileno.:_______________________Birthday:_____________________________________

School/ Grade or Year level / Course:_____________________________________________

Special Skills (ex.Playing musical instruments, dancing,singing,etc.):

_____________________________________________________________________

Other Seminars/ Retreats Attended:( extracurricular, religious, etc.)

______________________________________________________________________________

______________________________________________________________________________

II. Membership in School and Parish Organizations: ORGANIZATIONPOSITION POSITION

______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
III. Indicate illness that will require special attention:
_________________________________________________________________
_________________________________________________________________

IV. Parental Information

Name of Father:________________________________Occupation:________________

Name of Mother:________________________________Occupation:________________

Organizations of parents:
(If members of Couples for Christ indicate Area/Chapter).

Father:_________________________________________________________
Mother:________________________________________________________

Persons to notify in case of emergency

Name Relationship Phone Number______________________________________________

REPLYSHEET

A. FOR YOUNG ADULT PARTICIPATION IN CAMP

(Please check one)

_____I / We grant permission for our child/ children to attend.

Name of Children Age

____________________________________ _________

____________________________________ _________

____________________________________ _________

_____I/ We regret that our young adults cannot attend for the following reasons:

________________________________________________________________________

________________________________________________________________________

B. FORPARENTORIENTATION
(Please check one)

____Mother and Father will attend

____Father only will attend
____Mother only will attend
____Guardian will attend

______________________________ ______________________________
Father’s Signature Mother’s Signature
(Over printed name) (Over printed name)

______________________________

Guardian’s Signature
(Over printed name, state relationship to participant)

Address:____________________________________________________________________

Mobile Number ( Parents or Guardian):___________________