Events Form

Choose your event

Are you currently staff at YWAM Immerse Cornwall or YWAM Harpenden?

YesNo

Personal Information

First Name

Last Name

Gender

Date of Birth

Nationality

Email

Address

Phone/WhatsApp Number

Please keep me in touch with news from YWAM Immerse Cornwall

We need your consent to receive your application information and to contact you during the application process. By selecting the option to ‘Save my progress and resume later” at any time during the application process or by pressing the 'Submit' button when you have completed the form, you are providing that consent. You have the right to withdraw your consent at any time. To withdraw your consent, please email us at registrar@ywamharpenden.org. For more information about what we do with your personal data and how we protect it, see our privacy notice.

Family details

Is your family coming with you?

Yes

No

Name of Spouse (if accompanying you) Please make sure they fill out a separate application form

Please add details of any minors (name, age and gender)

Emergency Contact Information

Emergency Contact Name

Relationship To Applicant

Emergency Contact Phone

including international dialing code

Emergency Contact Email

Emergency Contact Address

Church Information

Church / YWAM Affiliation

When did you start attending this church? (if you are not YWAMer) or When did you join YWAM?

DD/MM/YYYY

Date

Church / YWAM Leader's Name

Church / YWAM Leader's Title / Role

Church / YWAM Leader's email

Church / YWAM Leader's phone number

Declarations

I give permission for my details to be held securely on the YWAM database

YesNo

I give permission for photographs to be taken for promotional purposes only

YesNo

Events Form

General Information

Family details

Emergency Contact Information

Personal Questions

Church Information

Declarations