YFN 2022 LEADER FORM 1GENERAL INFORMATION2REGISTRANT INFORMATION (LEADER)3MEDICAL INFORMATION4YFN 2022 LEGAL AGREEMENTS GENERAL INFORMATIONARE YOU REGISTERED WITH A CHURCH (OR GROUP) OR AS AN INDIVIDUAL?* CHURCH/GROUP INDIVIDUAL NAME OF CHURCH/GROUP* NOTE: A group is considered to be 2 or more people. If you are attending YFN with friends or family and ARE NOT affiliated with a church or youth group, please type the name of the person that submitted your registration/deposit payment. NAME ON ORIGINAL REGISTRATION* First Last REGISTRANT'S INFORMATION (LEADER)YOUR NAME* First Last HOME ADDRESS* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country EMAIL ADDRESS* PHONE NUMBER*GENDER* MALE FEMALE DATE OF BIRTH*Month123456789101112Day12345678910111213141516171819202122232425262728293031Year20232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920 MEDICAL INFORMATIONDO YOU HAVE ANY MEDICAL CONDITIONS WE SHOULD BE AWARE OF?* YES NO Examples: Epilepsy, Asthma, Arthritis, etc.PLEASE DESCRIBE BELOW* DO YOU HAVE ANY ALLERGIES WE SHOULD BE AWARE OF?* YES NO This includes food allergies // Examples: grass, nuts, dairy, etc.PLEASE DESCRIBE BELOW* DO YOU HAVE ANY DIETARY RESTRICTIONS?* YES NO Examples: Gluten-free, vegan, vegetarian, no tree nuts, no dairy, etc.PLEASE DESCRIBE BELOW* ADDITIONAL SPECIAL NOTES/REQUESTS YFN 2022 LEGAL AGREEMENTSThe portion below contains information pertaining to Legal Agreements.MEDICAL RELEASE*By e-signing and selecting "Yes" below, you are agreeing to the following: Youth for the Nations, Christ for the Nations Inc., and all other affiliates of CFNI will not be held liable for any injuries that occur or are sustained during the registrants' time at camp; You are giving Youth For the Nations consent to make any medical decisions deemed necessary in the event of an emergency during the duration of the registrants' time at YFN. YES, I have read, understood, and agree to the terms above. COVID-19 AGREEMENT*By e-signing and selecting "Yes" below, you are stating that you (the registrant) are fully responsible for the risk of contracting the virus known as COVID-19 by attending this event/camp. You are also stating that you (the registrant) will terminate your registration to YFN 2022 if you or someone you have been in contact with within the 14 days leading up to your scheduled camp arrival has tested positive or has shown active symptoms of COVID-19. YES, I have read, understood, and agree to the terms above. LIABILITY RELEASE OF ITEMS*I agree that any items lost or stolen are not CFNI or YFN's responsibility to find or replace. I release Christ for the Nations Inc., Youth For the Nations, and all other affiliates of legal liability for any event that may take place during the registrant's time of camp. YES, I have read, understood, and agree to the terms above. FULL NAME OF SIGNING REGISTRANT* First Last YOUR SIGNATURE* Δ
