Form title
Form description
Email address*
Valid email address
Surname
*Question
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Number
Text
Length
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Given name
*Question
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Email
*Question
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Description
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Number
Text
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A contact phone number
*Question
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Number
Text
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and
Number
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Parish / Mission Unit
*Question
Question Type
Description
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1.
All Saints, Palmerston North
2.
Avalon
3.
Brooklyn
4.
Carterton
5.
Castlecliff
6.
Chinese Anglican Mission
7.
Christ Church, Wanganui
8.
Churton Park
9.
Community of Rongotea
10.
Eastbourne
11.
Eastern Wanganui
12.
Eketahuna
13.
Gonville
14.
Greytown
15.
Hataitai-Kilbirnie
16.
Island Bay
17.
Johnsonville
18.
Kapiti
19.
Karori
20.
Kelburn
21.
Levin
22.
Lower Hutt
23.
Lyall Bay
24.
Milson
25.
Miramar-Seatoun-Strathmore
26.
Naenae-Epuni
27.
Newlands-Paparangi
28.
Northland-Wilton
29.
Onslow Anglicans
30.
Oroua
31.
Otaki
32.
Pahiatua
33.
Pauatahanui
34.
Petone
35.
Pohangina
36.
Porirua
37.
Rangitikei
38.
Roseneath
39.
Ruapehu
40.
Shannon-Foxton
41.
Silverstream
42.
South Wairarapa
43.
St Matthew's, Masterton
44.
St Matthew's, Palmerston North
45.
St Peter's on Willis, Wellington
46.
St Peter's, Palmerston North
47.
Stokes Valley
48.
Taihape
49.
Taita
50.
Tawa - Linden
51.
The Epiphany, Masterton
52.
Tinui
53.
Titahi Bay
54.
Trentham
55.
Upper Hutt
56.
Wadestown
57.
Waikanae
58.
Wainuiomata
59.
Waiwhetu
60.
Wellington Cathedral of St Paul
61.
Wellington South
62.
Whitby
63.
Blue Print Church
64.
St Mark's Network Church
65.
Urban Vision
66.
Other
1.
Other…
67.
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or
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Leadership role
*Question
Question Type
Description
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Priest
Youth
Children / families
Lay leader / accredited parish chaplain
Vocational deacon
Chaplain - school
Chaplain - armed forces
Chaplain - prison
Chaplain - hospital
Other…
Other…
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or
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Attendance
*Question
Question Type
Description
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1.
I am unable to attend
Continue to next section
2.
I will be attending
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1.
Other…
3.
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or
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Section title (optional)
Description (optional)
Spouse attending?
*Question
Question Type
Description
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Caption
1.
Yes
2.
No
3.
Not applicable
1.
Other…
4.
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or
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Spouse name
*Question
Question Type
Description
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Short answer text
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Number
Text
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Less than or equal to
Equal to
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Between
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Whole number
Number
and
Number
Custom error text
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Accommodation - on site or not for the two nights of 21 and 22 July?
*Question
Question Type
Description
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Caption
1.
Own camper-van or caravan
Continue to next section
2.
Staying off site
Continue to next section
3.
Staying on-site
Continue to next section
1.
Other…
4.
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or
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Children attending?
*Question
Question Type
Description
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Caption
1.
No
Continue to next section
2.
Yes
Continue to next section
1.
Other…
3.
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or
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Section title (optional)
Description (optional)
If you were at Ministry Conference last year would you be happy with the same room?
*Question
Question Type
Description
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Caption
1.
Yes, please
2.
Not bothered
1.
Other…
3.
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or
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If 'no', please say how we might make your stay for your family better this time.
*Question
Question Type
Description
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Short answer text
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Number
Text
Length
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Less than
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Between
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Number
and
Number
Custom error text
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Section title (optional)
Description (optional)
Name of child 1
*Question
Question Type
Description
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Short answer text
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Number
Text
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Between
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Age of child 1 (years) as at 1st July '16
*Question
Question Type
Description
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Number
Text
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Between
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Number
and
Number
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Gender of child 1
*Question
Question Type
Description
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1.
Male
2.
Female
1.
Other…
3.
Add option
or
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More children?
*Question
Question Type
Description
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Caption
Yes
Continue to next section
No
Continue to next section
Other…
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or
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Section title (optional)
Description (optional)
Name of child 2
*Question
Question Type
Description
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Number
Text
Length
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and
Number
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Age of child 2 (years) as at 1st July '16
*Question
Question Type
Description
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Number
Text
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Between
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and
Number
Custom error text
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Gender of child 2
*Question
Question Type
Description
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1.
Male
2.
Female
1.
Other…
3.
Add option
or
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More children?
*Question
Question Type
Description
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Yes
Continue to next section
No
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Name of child 3
*Question
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Age of child 3 (years) as at 1st July '16
*Question
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Number
Text
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Between
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Number
and
Number
Custom error text
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Gender of child 3
*Question
Question Type
Description
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Caption
1.
Male
2.
Female
1.
Other…
3.
Add option
or
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More children?
*Question
Question Type
Description
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Caption
Yes
Continue to next section
No
Continue to next section
Other…
Add option
or
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Section title (optional)
Description (optional)
Name of child 4
*Question
Question Type
Description
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Number
Text
Length
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Less than
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Between
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and
Number
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Age of child 4 (years) as at 1st July '16
*Question
Question Type
Description
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Short answer text
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Number
Text
Length
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Between
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Number
and
Number
Custom error text
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Gender of child 4
*Question
Question Type
Description
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Caption
1.
Male
2.
Female
1.
Other…
3.
Add option
or
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More children?
*Question
Question Type
Description
Loading image...
Caption
Yes
Continue to next section
No
Continue to next section
Other…
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or
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Section title (optional)
Description (optional)
Name of child 5
*Question
Question Type
Description
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Number
Text
Length
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Number
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Age of child 5 (years) as at 1st July '16
*Question
Question Type
Description
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Short answer text
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Number
Text
Length
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Less than
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Between
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and
Number
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Gender of child 5
*Question
Question Type
Description
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1.
Male
2.
Female
1.
Other…
3.
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or
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More children?
*Question
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Description
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Caption
Yes
Continue to next section
No
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or
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Name of child 6
*Question
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Text
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Number
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Age of child 6 (years) as at 1st July '16
*Question
Question Type
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Caption
Short answer text
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Number
Text
Length
Regular expression
Greater than
Greater than or equal to
Less than
Less than or equal to
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Between
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Number
and
Number
Custom error text
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Gender of child 6
*Question
Question Type
Description
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Caption
1.
Male
2.
Female
1.
Other…
3.
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or
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Sharing - is there someone you wish to share a room with?
*Question
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Description
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Number
Text
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Please indicate if you are unable to use an upper bunk bed.
*Question
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1.
Yes - I am UNABLE to use an upper bunk bed
2.
No - I would be OK with an upper bunk
1.
Other…
3.
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Do you require a single room?
*Question
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1.
No - happy to share
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2.
Yes
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1.
Other…
3.
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Do you wish to pay the $60 premium to secure a single room ?
*Question
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1.
Yes
Continue to next section
2.
No
Continue to next section
1.
Other…
3.
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or
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Meals
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Special diets
*Question
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Description
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Vegetarian
Diabetes
Coeliac (total gluten-free)
Dairy-free
Other
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Select at most
Select exactly
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Special diet details
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Other information - either info we need, or you wish to share
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Medical conditions
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Any other registration information we should be aware of?
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Are you able to help in any way with the running of the event? Please indicate and we will be in touch.
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Leadership role
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Attendance
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Spouse attending?
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Spouse name
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Accommodation - on site or not for the two nights of 21 and 22 July?
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Children attending?
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If you were at Ministry Conference last year would you be happy with the same room?
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If 'no', please say how we might make your stay for your family better this time.
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Name of child 1
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Age of child 1 (years) as at 1st July '16
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Name of child 2
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Age of child 2 (years) as at 1st July '16
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Age of child 3 (years) as at 1st July '16
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Name of child 4
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Age of child 4 (years) as at 1st July '16
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Name of child 5
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Age of child 5 (years) as at 1st July '16
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Name of child 6
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Age of child 6 (years) as at 1st July '16
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Gender of child 6
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Sharing - is there someone you wish to share a room with?
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Please indicate if you are unable to use an upper bunk bed.
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Do you require a single room?
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Do you wish to pay the $60 premium to secure a single room ?
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Meals
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Special diets
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Special diet details
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Medical conditions
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Any other registration information we should be aware of?
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Are you able to help in any way with the running of the event? Please indicate and we will be in touch.
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