Potential Love & Movie Date (Jamaica) JA $8000
Registration Form
Email *
Name *
Basic Information
Personal
Age *
Sex *
Address *
Contact *
Occupation *
Which Day Would You Like To Attend *
Dating Category
We Do Not Endorse Linking of Seventhday Adventist with Non-Seventh-day Adventist for Dating. Thus we will always purpose to link you with the dating category you fall in.
Which are you? *
Church Verification
Church of Regular Attendance/ Membership *
Contact Information of One Official Entity that Can Verify Your Membership/ Attendance. (Contact information should include the name of the church; like a church email, church instagram page. You should also notify said contact that we will be contacting just to verify your membership/ regular attendance at that church) *
Name of Person Being Contacted at Contact Information *
Emergency Information
Name, (Relation), Address, Phone Number of Emergency Contact *
Medical Information
Do you have any health issues? *
What is this?
Will you be taking adequate medication along? *
Do you have any disability? *
Do you require special arrangements/ provisions to be made for you because of a disability? *
If you do, what is this?
Food
Soda/ Orange (Natural Juice) & Popcorn ( Small - Medium)
Only The Above Food Description Will Be Purchased By Us. But Should You Desire More, You Are Free To Inform Us And Purchase Any Non-Meat Food That You Like *
Do you have any allergies *
If yes, please state?
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