Launch 2025 Leaders Registration

Name(Required)

First Last

Email(Required)

Mobile(Required)

Church Name and Suburb(Required)

Dietary Requirements/Allergies/Intolerances (leave blank if none)

Medical issues of which we should be aware (leave blank if none)

Emergency Contact Name(Required)

Emergency Contact Number(Required)

Date of Birth(Required)

Please enter your date of birth for WWC verification.

WWCC Number(Required)

Please enter your Working With Children Check number.

WWCC Expiry Date(Required)

Please enter the expiry date of your Working With Children Check.

Have you completed Safe Ministry Training?(Required)

Yes

No

Other

Safe Ministry Expiry Date(Required)

Please enter your Safe Ministry Training expiry date.

Hidden

Ticket Type(Required)

Launch 2025 Leader

Total

Credit Card(Required)

Phone

This field is for validation purposes and should be left unchanged.