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Register for Equip

Equip Registration 2019

Please complete the following registration for Equip 2019.

1. Student Name (First):

2. Student Name (Last):

3. Date of Birth:

4. Gender:


5. Student Email:

6. Student Street Address:

7. Student City:

8. Student State:

9. Student Zip Code:

10. In the 2019/20 school year, this student will be a:

High School Freshman
High School Sophomore
High School Junior
High School Senior
College Freshman

11. Parent/Guardian Name (First):

12. Parent/Guardian Name (Last):

13. Parent/Guardian Email:

14. Parent/Guardian Phone:

15. Parent/Guardian Address (if different from student):

16. Church Name:

17. Church Address:

18. Name of Pastor:

19. School Name:

20. How did you hear about Equip?

21. Have you made your $100 deposit?


22. Will you need transportation to or from Logan International Airport?


23. Do you know anyone who may be interested in coming to Equip with you?