Medical Camp Registration Form

Personal Information

First Name*

Last Name*

Email*

Contact Number*

Gender*

MaleFemale

Service Support

Please indicate how you would like to remit your support for the medical camp:

In Kind Support

Availabity and Attendance

Experience

Do you have any previous experiences in conducting a medical camp?

YesNo

Consent & Confirmation

I consent to be contacted by the organizing team for updates and coordination*

True

Any message or prayer request you'd like to share with the organizers?

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