PURITY FIRST REGISTRATION FORM

FIRST NAME ___________________________LAST NAME __________________________ AGE______

NAME THAT YOU PREFER TO BE CALLED ________________________________________

STREET ADDRESS: _________________________________________________________
CITY: ______________________________________ STATE: ________ ZIP: __________
E-MAIL ADDRESS: __________________________________________
HOME PHONE:______________________________________________

The total cost is $150. Payment Included? Y or N Check#_____________ (All payments are non-refundable)

 

My personal definition of purity is: _______________________________________________
____________________________________________________________________________

 

The specific areas that I am interested in discussing and exploring are: ___________________________________________________________________________
___________________________________________________________________________

Lunch will be provided. Do you have any food allergies or dietary restrictions? Y or N
If so, what are they? _________________________________________________________
___________________________________________________________________________

 

I__________________________________ parent of_______________________________ agree to let my child participant in the upcoming Purity First! training at _______________________________________________.

 

I understand that the purpose of PURITY FIRST! is to uncover and recover the inherent beauty, purity and dignity of individual sexuality as created by God, and to experience confidence, responsibility and freedom through committed loving relationships with God and others.

_______________________________________________________            ______________
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