Infusion Kona Application Order Number We're excited to have you in Kona, Hawaii! -- Help us get you there! Fill out the questions below and click the SEND button. We will send you a follow up email with forms to fill out and a payment link!! First Name: Last Name: Gender: * Male Female Email Address: * Your Phone Number: * Date of Birth: * Age: * Parent's Email Address: * Parent or Guardians Name(s): * Parent or Guardian's Phone Number: * Street Address: * City: * State: * Zip: * T-shirt Size: Small Medium Large XL XXL XXXL Youth Group Name/Church: Are you coming with your youth group? Yes No Are you coming with a friend? Yes No Infusion realizes modesty is at times culturally relevant, but we choose to outdo in honor as the Bible teaches. Our standard at the beach for girls is a one piece bathing suit or tank top over bikinis, and for guys, no speedos. * Great! Tell us about yourself... What's your salvation experience? * Why do you want to come to Infusion? What are you hoping to learn? * Any health problems we should know about? * Food or Drug Allergies/Intolerances * Have you ever had a drug or alcohol problem? * List any symptoms you've had with mental illness i.e. depression, anxiety, suicidal thoughts, self harm, ADHD, ADD, bipolar disorder, PTSD, eating disorder *
