Wholeheart Advance 2020 – Georgia: April 23-26

Registrant Full Name *

Registrant Phone *

Registrant Email *

Spouse/Emergency Contact (full name) *

Spouse/Emergency Contact Phone *

Spouse/Emergency Contact Email *

D-Group Are you involved with a D-Group?
 * I am in a D-Group
I lead a D-Group
I am not in a D-Group

Shirt Size for the Advance * Please select shirt sizeMEDIUMLARGEXLXXLXXXL

PHOTO/VIDEO RELEASE
I agree to grant The Road the right and permission to use photographs and/or video recordings taken during the Advance, during the dates of April 23rd-26th, 2020 on websites, social media, in publications, promotional flyers, media screens or for any other similar purpose without compensation to me. I understand and agree that such photographs and/or video recordings of myself may be placed on the Internet. This Release covers the person registered on this form. Payment for ticket(s) counts as your signature for this release.
 * YES
NO