Tag: gathering

Here’s a Neftaly Registration Form Template for gathering participant information:

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Neftaly Registration Form

Participant Information:

1. Full Name:
   • (First Name, Last Name)
2. Date of Birth:
   • (MM/DD/YYYY)
3. Gender:
   • (Male / Female / Non-binary / Prefer not to say)
4. Email Address:
   • (Primary Email)
5. Phone Number:
   • (Mobile Number)
6. Address:
   • (Street Address)
   • (City, State, ZIP Code)

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Emergency Contact Information:

7. Emergency Contact Name:
   • (Full Name)
8. Emergency Contact Relationship:
   • (e.g., Parent, Spouse, Friend)
9. Emergency Contact Phone Number:
   • (Mobile Number)

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Health Information:

10. Do you have any pre-existing medical conditions or allergies?
    • (Yes / No)
      If yes, please provide details:
    • (Text Box)
11. Are you currently taking any medication?
    • (Yes / No)
      If yes, please provide details:
    • (Text Box)
12. Fitness Level:
    • (Beginner / Intermediate / Advanced)

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Activity Consent:

13. Please indicate your interest in participating in the following activities:
    • Bungee Jumping: (Yes / No)
    • Zip-Lining: (Yes / No)
    • Skydiving: (Yes / No)
    • Other Activities (Specify): (Text Box)

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T-Shirt Size (Optional):

• (Small / Medium / Large / X-Large / XX-Large)

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Liability and Safety Acknowledgment:

14. Do you agree to the terms and conditions, including the waiver of liability, for participating in extreme sports activities at the Neftaly camp?
    • (Yes / No)

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How did you hear about Neftaly?

• (Referral / Social Media / Website / Other)

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Additional Comments or Questions:

• (Text Box)

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Submit Registration:

• (Button)

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This simple form captures essential participant information, emergency contact details, health information, activity preferences, and consent for participation. You can modify or expand this form as needed to align with your specific requirements.