Youth Connect

Youth Connect

Register Below
Name*

First NameLast Name
Age*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Gender*

MaleFemale
E-mail*
Phone Number*

Area CodePhone Number
Emergency Phone Number*

Area CodePhone Number
Emergency Contacts Full Name*
Emergency Contacts Relation To You*
Check the box to legally agree to these guidlines*

I agree to behave in a safe and respectful manner, to always communicate my where-abouts with a team leader and I take self responsibility and will not hold Kindred Youth liable for not doing so. (if under 16) I have spoken to my parents/guardians and I have their consent to me coming to 'Youth Connect'.
Signature*

Contribution

Full pass (food & acomm inc)$30.00AUD

1day / night ticket (food & accom inc.)$20.00AUD

Enter coupon