PAN EUROPEAN ADVENTIST YOUTH CONGRESS

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Name*

First

Last

Address*

Address 1

Address 2

City

Province/State

Postal Code

Country

Age on 30 July 2013*

Date of Birth*

yyyy/mm/dd

Mobile Number*

Home Telephone

Email*

Home Conference/Mission*

Home Union*

Special Dietary Requirements. Please specify food intolerances only.

PASSPORT: Date of Issue.*

dd/mm/yyyy

PASSPORT: Date of Expiry*

dd/mm/yyyy

PASSPORT: Place of issue*

Travel Insurance*

I have travel Insurance

I will arrange travel insurance

Age*

Over 18

Under 18

For under 18's onlyThis serves as an agreement that my child/ren can attend Congress and will be fully supervised by a responsible adult.

Under 18's only. Parent/Guardian please select

T-Shirt Size*

Agreement.*I agree to support all activities and to respect the philosophy of the Seventh-day Adventist Church whilst attending the Pan-European Youth Congress in Novi Sad,Serbia.

Agree

Disagree

Online Transfer Payment Reference. Please use Ref 'CHEQUE' if you are paying by cheque.*

Seventh-day Adventist® Church

Adventist Youth in the United Kingdom and Ireland

PAN EUROPEAN ADVENTIST YOUTH CONGRESS