Community Chaplains Training Day Registration
Which training day are you registering for?
*
12 July, Waikato
Are you registering for yourself or a group?
*
Myself
Group
How many are in your group?
Name
*
First Name
Last Name
Email
*
example@example.com
Phone number (mobile preferred)
*
What church do you belong to?
*
Name 2
*
First Name
Last Name
Email
*
example@example.com
Phone number (mobile preferred)
*
What church do you belong to?
*
Name 3
*
First Name
Last Name
Email
*
example@example.com
Phone number (mobile preferred)
*
What church do you belong to?
*
Name 4
*
First Name
Last Name
Email
*
example@example.com
Phone number (mobile preferred)
*
What church do you belong to?
*
Name 5
*
First Name
Last Name
Email
*
example@example.com
Phone number (mobile preferred)
*
What church do you belong to?
*
Do you have any dietary requirements?
Yes
No
Dietary Requirements
*
Gluten Free
Dairy Free
Vegetarian
Other
Does anyone in the group have any dietary requirements?
Yes
No
Gluten Free (please indicate number)
Dairy Free (please indicate number)
Vegetarian (please indicate number)
Other (specify what and please indicate number)
How did you hear about Community Chaplains?
*
Through my church
Facebook or Social Media advertising
Word of mouth (not through church)
Google search
Other
My Products (please select one person in the group e.g. if there are 5 in your group choose 5 in quantity)
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CC Training Day
Training day, manual and lunch.
$
80.00
NZD
Quantity
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
In the event that the training day is cancelled a full refund will be issued. In the event that you are unable to attend a partial refund of $70 will be issued.
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