RSVP 2 — A2MIA

APPLICATION FOR

Please complete the form below as an application to be considered a participant in The Journey 2 Purpose, brought to you by A2MIA.

Name

First Name

Last Name

Phone

(###)

###

####

Do you agree to raise $500 in donations towards this experience?

Are you 18 years of age or older?

Do you agree to a physical exam to ensure your physically able to partake safely in this journey?

Have you read all the Quick Facts to ensure you're aware of all dates, rules, and details?

Part 1: Who are you? And what is your story?

250 word minimum (500 word max)

Part 2: Why do you want to take part in The Journey 2 Purpose?

250 word minimum (500 word max)