REVIVE REGISTRATION Which program are you registering for? Manitoba Saskatchewan Alberta British Columbia CHURCH DETAILS Please provide us with information about your church/youth group. Youth Pastor's Name * First Name Last Name Church Name * Church Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Line Number of youth attending * Names of youth attending * Number of leaders attending * Names of leaders attending * SPECIFIC LIMITATIONS By checking this box I acknowledge that each youth and leader must also fill out an individual student or leader registration form. I acknowledge that this form is not an official registration and is instead an aid to Street Invaders in preparing for the Revive Retreat and informing Youth Pastors of necessary information. * I agree. Thank you!
