Mid Year Days Away 2024 event registration

I will be registering as *

Select your category *

First Name *

Last Name *

Preferred Name

This will be printed on your name tag.

Preferred Email *

As all future communication and emails will be sent to this address, be sure to check that it is correct. The automated confirmation email will only go to this email address.

Mobile Number *

Date of Birth *

Gender *

First Name - Spouse *

Last Name - Spouse *

Preferred Name - Spouse *

Preferred Email (Spouse) *

As all future communication and emails will be sent to this address, be sure to check that it is correct.

Select your university *

Please write which university you attend

Which year of uni are you in for 2024? *

Are you due to graduate in the next 6-12 months? *

Which Power to Change worker/leader knows you best? (who invited you to join)? *

Please write the person in Power to Change who invited you or who knows you best *

Room Allocations

Please list three people with whom you would like to share a room and every effort will be made to put you with at least one of these people.

Emergency Contact Name *

Please give the details of someone we can contact for you in the event of an emergency. The person must be 18 years or older. (For married couples attending the conference together, this must not be your spouse.)

Emergency Contact Number *

Alternate Contact Number

Medical Conditions

Please give details of any medical conditions that are or may be relevant to your attendance. If your condition requires medication, please specify if you are bringing your own.

Please indicate if you have any of the following dietary requirements:

Do you have other special dietary requirements?

Are you an International Student? *

If yes, which country are you from? *

Provider

If you are an international student, please provide your overseas health cover details which may be used in the case of an emergency.

Your name as it is on the policy

Policy Number

Name of your closest family member or friend in your home country to contact in the case of an emergency *

Contact phone number *

Rate your English

Do you have children who will attend MYDA 2024?

Please list children only on one registration form. DO NOT list on both the parents registration forms.

Do you wish for your child/children to be looked after by childcare?

Name of Contact Person

Email

Phone Number:

How many children are in this registration? *

Child 1 - Name *

Child 1 - Age in June 2024 *

Child 2 - Name

Child 2 - Age in June 2024

Child 3 - Name

Child 3 - Age in June 2024

Child 4 - Name

Child 4 - Age in June 2024

Child 5 - Name

Child 5 - Age in June 2024

Please tell us a bit about yourself *

I am a follower of Jesus and want to grow in my faith

I am a follower of Jesus who started following Jesus in the last year

I am exploring who Jesus is

I am open to spiritual discussions and am coming with friends who invited me

Other

Training Modules *

Preference(s) for Leading Training *

Cancellation Policy *

Please note that you must pay by the deadline for your registration to be processed. If payment or the remittance advice of payment has not been received by the deadline, your registration will be considered void (cancelled).

There are no refunds for cancellations of your registration after the deadline.

Please tick both boxes above to acknowledge you have read and understood the cancellation policy.

Photographs and videos taken at Mid Year Days Away 2024 may be used by Power to Change online or in future promotional material. If you would like to speak to someone about this, please email ashley.wilson@powertochange.org.au

Privacy Statement *

©Power to Change ABN 25126098398 is an international faith based mission that connects people to Jesus and each other. We respect your privacy and will only use your information to do what you have asked (eg. registration / donation / subscription) and to keep you informed of our work. We will not pass your details onto unrelated third parties and we will allow you to opt out of our publications. See our Privacy Policy at www.powertochange.org.au

Please tick the box above to accept these terms and conditions.

Can you think of any additional info that might be helpful for the Conference organisers to know about your registration?

Payment Method *

Click the Process Registration button below to submit your registration. If you have chosen to pay via Bank Transfer, please make payment to the following bank account: Name: PTC Campus NSW BSB: 062107 Account Number: 10691032 Description: [Name] MYDA 2024 Any cash payments should be given to your local Power to Change missionary. Thank you!

Support Account Number *

Your payment will be deducted from your support account before the camp.

Amount

Discount Amount

Gross amount

Coupon

Payment Method *

Select a payment option above Or pay by Credit Card

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Type*

Card Holder Name*

*

Verification code*

Registration

Personal Information

Personal Details - Spouse

Emergency Contact Details

Other International Student Information

Overseas Student Health Cover Details

Information for Childcare

Experiences

Policies

Payment Info

Payment Information