Study Week Registrations w/ Stripe

Study Week 2026 Registrations

Get in shape today
Full Name*

First NameLast Name
E-mail*
Phone Number*

Country CodePhone Number
Date of Birth*

DayMonthYear
State*
Ecclesia*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender*

MaleFemale
Medicare number*
(Must include personal identification number at the end)
Baptised*

YesNo
Married*

YesNo
Who do you want to be in a room with?
Emergency contact full name*
Emergency contact phone number*

Country CodePhone Number
Would you be interested in helping with music during Study Week? (Check all that apply)*

Yes - I can play an instrument (specify in the question below)Yes - I'm comfortable singing solo, or in a small groupYes - Choir (Soprano)Yes - Choir (Alto)Yes - Choir (Tenor)Yes - Choir (Bass)No - My only instrument is a triangle
If yes, please share any details (Instrument, Solo or Group, etc.)*
If no, please type 'N/A'
I am qualified in first aid and willing to help*

YesNo
Dietary requirements (Select all that apply)(There will be an additional $100 fee for dietary requirements)

Gluten FreeDairy FreeOther
I have medical requirements (List below)
My Products
prevnext( X )
Deposit$76.58AUD
Non-refundable. Includes service fee.

Total $0.00AUD
T's & C's*

I have read and agree to the Study Week 2026 Terms and Conditions
Should be Empty:

Study Week 2026 Registrations