UNITE '22 Individual Registration
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Email *
Full Name *
Age Group (Pick One) *
Required
Age *
Grade *
Address *
City *
State *
Zip Code *
T-Shirt Size  (Pick One)  [Adult sizes] *
Parent/Guardian Full Name
Parent/Guardian/Adult participant Phone # *
Parent/Guardian Email (if different than above email)
Home Church (if applicable)
Are you willing to climb ladders (with parent/guardian permission)? *
Required
Have you ever helped paint a house? *
Required
Do you give consent for UNITE  to use your youth's (or adult participant's) image in media (both video and photography) throughout the course of UNITE and on UNITE's website, social media sites and documents? *
Required
Crew Request: If you would prefer to be grouped with another participant in the same crew, please list the names here:
Do you want to be contacted about receiving a  scholarship for the UNITE registration fee?
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If you have any specific needs not listed or information about you for the UNITE leaders, please share...
Will you be able to stay over night at the camp site, Bethel Reformed Church during the event?  If not, please explain. (Our hope is that all participants are fully plugged-in to UNITE for the duration of the event (including overnight), but understand that some circumstances make this difficult for some students and adults.)
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