Breakthrough Youth Conference 08

Contact Information

First Name Last Name Street Address Suburb Town Postcode Email Address Mobile Phone Work Phone Home Phone

Emergency Information

Emergency Contact Name Phone Relationship

Church Details

Church Youth Pastor's Name

Group Details

If you are part of a group, please provide the following details:

Group Name Group Leader Name

Stream

Please indicate how many people within your group are attending each stream.

Age 13+ Age 11-13

Tee-shirt ($25)

Marae Accommodation ($25)

I would like Marae Accommodation.

The Gathering 09

I am a Youth Pastor / Leader and would also like to register for the Gathering. ($20) More information.

Church Role

VISION	ACCOMMODATION	REGISTRATION	SPEAKERS	PROGRAM	COOL STUFF	CONTACT US
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