WORLD YOUTH DAY 2002

PARTICIPANT REGISTRATION FORM - Diocese of Nelson

_____________________________________________________________________________________

Personal Information

PLEASE USE BLOCK, CAPITAL LETTERS

 

Legal Name;   ____________________________   __________________________________________

(as it would appear                            FIRST NAME                                                         LAST NAME

on your passport)

 

Mailing Address:  _____________________________________________________________________

                                                STREET                            CITY                             PROVINCE                      POSTAL CODE

Home telephone:  _____________________        Email:  ________________________________

Date of birth:  ____    ______   _____   Sex:   __ M    __ F          Home Parish:  ____________________

                                Mm             dd                    yy

_____________________________________________________________________________________

Contact Information

Please give the name of parent or guardian who consents to your participation in this event. If you are 18 years or older, please give the name of a friend or relative whom we may contact in the case of emergency.  (This should not be someone accompanying you to Toronto.)

 

Check one:   ____ Parent   _____ Guardian     ____ Relative  ___ Spouse   _____  Friend

 

Name: ____________________________    __________________________________

                     FIRST NAME                                                                  LAST NAME

 

Mailing Address:  __________________________________________________________________

 

Home telephone: _______________________    Work telephone:  ______________________________

 

other number: _________________________________

_____________________________________________________________________________________

Payment

**Travel space is limited. All payments must be on time to guarantee your space.

 

Cheques payable to "World Youth Day 2002"

 

________ Cheque in the amount of $600 is enclosed                I prefer:

                to cover my deposit                                                    ______ simple accommodations   

                                                                                                   (billeting, school stay, etc.)

                Balance due by April 1, 2002                                    _____ deluxe accommodations

                                                                                                   (hotel – extra cost)

_____________________________________________________________________________________

Please remember to sign your application.

 

Signature of applicant: _____________________________________  Date:  ____________________

 

I am the parent or legal guardian of the above (minor) applicant.

 

Signature of parent or legal guardian:  _________________________  Date:  ____________________

 

MAIL COMPLETED REGISTRATION FORM AND CHEQUES TO:

WORLD YOUTH DAY 2002, Deb Jacyna, St. Ann’s Parish, 1296 Main St., Penticton, BC V2A 5G2