Registration Form: Carlsbad Sister City Youth Ambassador Exchange Program
June 15-24, 2020
Participant Passport Information
* All information must be as same as the valid passport.
* If you do not have a passport, please skip to the next question.  
First and Middle Name (Given names)
Last Name (Surname)
Date of Birth
HH
/
NN
/
ÉÉÉÉ
Title (Student, Chaperone, or Teacher)
E-mail Address
Phone Number
Mailing Address (Street)
Mailing Address (City)
Mailing Address (Zip Code)
Name of Parent or Guardian
Parent or Guardian  (E-mail Address)
Parent or Guardian (Phone Number)
Relationship to participant
Emergency Contact (if different than above)
Emergency Contact (Phone Number)
Relationship to participant
Diet Request and Allergy
List of Allergies
Known Medical Conditions
Thank you.  An e-mail confirmation will send out within 24 hours after submission.  For any questions, please contact us at info@asiagetaway.com.
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