Rev5 Summer Intensive Application

Name*
First Last
Phone*
Email*
Address*
City State
What is your T-shirt size?
How old are you?*
What grade are you entering in Fall 2021?*
Fitness Level*
Intensive may involve activities requiring stamina and basic physical fitness. How would you describe your fitness level?
Additional Medical Info
Please provide any health information that might impair your ability to exercise, limit athletic performance, or any other relevant info (including food allergies).
Describe your relationship with Christ.*
How did you hear about Rev5 Summer Intensive?*
What are you most excited to gain from your Rev5 Intensive experience?*
Emergency Contact Name*
Please list your legal guardian as your emergency contact person. They will receive an email with a digital Release of Liability waiver that must be signed and submitted before you can participate in Rev5 activities.
First Last
Emergency Contact Relation*
Emergency Contact Phone*
Emergency Contact Email*