MEN'S HEALTH AWARENESS WORKSHOP REGISTRATION

MEN'S HEALTH AWARENESS WORKSHOP REGISTRATION

FRIDAY, JUNE 5, 2026 || 7PM & JUNE 6, 2026 || 8AM - 4:30PM (FREE Event)
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Are you a minor (under 18)?
If yes:
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Do you have a church home?
If yes, what is the name of your church?
Hold Harmless Agreement
By registering for and attending this event, I acknowledge that I am participating voluntarily and at my own risk. I agree to hold harmless and release the event organizers, leaders, volunteers, and hosting facility (International Praise) from any liability for illness, injury, accident, loss, or damage that may occur during the retreat.
I also understand that I am responsible for my own health, safety, and belongings throughout the event.

By signing below, I affirm that I have read and understood this agreement.
Electronic Signature & Date
Date

MonthDayYear
Date
Should be Empty: