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Safe Transport
Nuvia offers safe and reliable transport for participants. Register here to request pickup and drop-off support for your program sessions.
Participant's Full Name
*
First Name
Last Name
Phone Number
*
Participant Age Group
*
Please Select
13-15
16-18
19-25
Address/Zone
*
Please Select
Zone 1 (Douala Central): Akwa, Bonanjo, Bali, Bonapriso, Ngodi, Bessengue, 4e.
Zone 2 (Douala Bridge West): Bonaberi (entire area), Deido (via rond-point).
Zone 3 (Douala Northwest): Bonamoussadi, Makepe, Logpom, Logbessou, Cité des Palmiers, Akwa Nord, Hôpital Général.
Zone 4 (Douala North East): Ndokoti, PK8-PK14, Ndogbon, Bepanda, Nyalla, Génie Militaire, Cité CIC.
Zone 5 (Douala South East): Village, Yassa, Yatika, Dakar, Lendi, possibly Mabanda.
Preferred Pickup Point
*
Dates Needed
*
Please Select
Once a week (Healing Circles)
Once a month (Workshops)
Occasional
Please provide specific dates
*
Pickup/Dropoff?
*
Please Select
Pickup only
Dropoff only
Both
Back
Next
Guardian's Consent Form
Guardian Full Name
*
First Name
Last Name
Parent's Phone Number
*
Please enter a valid phone number.
Parent's Email
*
example@example.com
Address/Zone
*
Please Select
Zone 1 (Douala Central): Akwa, Bonanjo, Bali, Bonapriso, Ngodi, Bessengue, 4e.
Zone 2 (Douala Bridge West): Bonaberi (entire area), Deido (via rond-point).
Zone 3 (Douala Northwest): Bonamoussadi, Makepe, Logpom, Logbessou, Cité des Palmiers, Akwa Nord, Hôpital Général.
Zone 4 (Douala North East): Ndokoti, PK8-PK14, Ndogbon, Bepanda, Nyalla, Génie Militaire, Cité CIC.
Zone 5 (Douala South East): Village, Yassa, Yatika, Dakar, Lendi, possibly Mabanda.
Preferred Pickup Point
*
Dates Needed
*
Please Select
Every Saturday (Healing Circles)
Once a month (Workshops)
Occasional
Please provide specific dates
*
Pickup/Dropoff?
*
Please Select
Pickup only
Dropoff only
Both
Parent's Full Name
*
First Name
Last Name
Parent's Signature
*
Today Date
*
-
Month
-
Day
Year
Date
Submit
Submit
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