Kairos South Pacific

When God acts, we must respond!

Pitstop 2010 Online Rego

*What is your name? *Male or Female?
Male
Female
*What is your address? What is your phone number/mobile number? *What is your age as of January 1, 2010?
13
14
15
16
17
18
19
20
21-24
25 and up
*Do you have a full car license?
Yes
No
*Do you have a vehicle available for use?
Yes
No
*Have you attended a Life in the Spirit Seminar?
Yes
No
*What you attended Summer Oasis or Winter V?
Yes
No
What is your church affiliation? *Do you require accommodation?
Yes
No
What is your arrival date and time? What is your departure date and time? *How many nights are you staying?
One
Two
Three
Four or more
Please specify any special needs (dietary, medical or physical)
Do you have any other comments?

DEADLINE FOR REGISTRATION - APRIL 1, 2010

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