IPC Retreat 2022 Registration

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Pendaftaran IPC Retreat 2022

Full Name (nama) *

Email (alamat email) *

Mobile number (nomor telpon) *

Gender (kelamin) *

Male (laki)

Female (perempuan)

Will you be staying over or a day visitor? (Apakah Anda akan menginap atau pengunjung harian?) *

Day Visitor (Pengunjung harian) - Saturday

Day Visitor (Pengunjung harian) - Sunday

Staying Over (Menginap)

Do you require a permission slip? (Anda perlu mengisi surat izin orang tua/wali?) *

A permission slip is required only if (surat izin orang tua/wali diperlukan jika): 1) You will be under 18 during Retreat AND (Anda di bawah usia 18 tahun selama Retreat, DAN) 2) Your parent/guardian is not attending Retreat (orang tua/wali Anda tidak ikut Retreat)

Yes (ya)

No (tidak)

Which service do you go to? (ibadah yang biasa Anda hadiri) *

HIPC - English

HIPC - Indo

IPC 8:30 am

IPC 11:30 am

Kingsway AM

Kingsway PM

Liverpool

Oneway

Sunday School/Kid's Church

Other:

Payment method (metode pembayaran) *

Cash (tunai)

Bank transfer (transfer)

Additional payment options (tambahan metode pembayaran)

Someone will get into contact with you regarding your response (Anda akan dihubungi mengenai jawaban yang Anda pilih)

I may need help to cover the cost of the retreat (saya butuh bantuan untuk memenuhi biaya Retreat)

I would like to help those who can't afford the cost by paying extra (saya ingin memberi sumbangan sukarela untuk membantu mereka yang kurang mampu memenuhi biaya retreat)

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Are you able to drive other people in your car? If so, please indicate how many people and the suburb you will be driving from (Apakah orang lain boleh ikut numpang di kendaraan Anda? Jika iya, harap beritahu jumlah orang dan suburb awal perjalanan Anda).

Will you need transport to Camp? If so, please indicate which suburb you will need to be transported from (Apakah Anda butuh transportasi ke Retreat? Jika iya, harap beritahu Anda perlu dijemput dari suburb mana). *

Name of emergency contact (nama kontak darurat) *

Relationship of emergency contact with you (hubungan kontak darurat dengan Anda) *

Emergency contact number (nomor telpon kontak darurat) *

Dietary requirements / Allergies / Medical conditions (if any) (Persyaratan diet / Alergi / Kondisi medis, jika ada)

Symptoms and treatment for dietary requirements / allergies / medical conditions (gejala dan perawatan untuk persyaratan diet / alergi / kondisi medis)

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