Application Form

This application form is purely for reserving you place on Youth Week 2009, your place will however only be confirmed once we have received payment in full for your camp costs. Camp costs will be communicated to you by your regional representative. Camp costs vary depending on the region you are coming from.

If you would like to use the regional transport arrangements, please indicate this on the form. Your regional representative will then be in contact with you. If you have any questions, please feel free to contact us.

We look forward to seeing you at Youth Week 2009!
 
Personal Details
Applicant's Full Name:
E-mail
Telephone Number:
Cell Phone Number:
Address:
Age:
Gender:
Language:
T-Shirt Size:

(Early applications will get preference on sizes)

 
Regional Details
Region:
Transport:  
I would like to make use of regional transport arrangements
 
Medical Details
Medical Aid Name:
Medical Aid Number:
Type of Plan:
Principal Member:
Principal Member Tel:
 
Youth Week Payment Details

YFC Training Centre

Standard Bank Krugersdorp

Branch Code: 015841

Account Number: 021347425

 
(Proof of payment may be faxed or e-mailed to the central contact person)
 
Terms & Conditions
I, the applicant, agree to abide by the rules and regulations of Youth Week 2009 and will endeavor to be responsible in my participation of the programme during this event
Yes
I agree to the terms and conditions set forth in the Letter of Consent / Indemnity.
Yes
 
 
Important Notice!
Please note that each applicant will be required to bring an original signed indemnity form to the camp. If under the age of 21, the indemnity must be signed by a parent or legal guardian.