Aurora Sister Cities International


2024 Youth Exchange to Jaco, Costa Rica Participant Information and Releases
First Name
Last Name
Date of Birth
Gender
Phone
Email
Address 1
Address 2
City
State/Province
Zip
Do you currently have a valid passport?	Yes No
Parent/Guardian Information
Relationship to Participant
Parent/Guardian 1
Parent/Guardian Email 1
Phone Type
Parent/Guardian Phone 1
Phone Type 2
Phone2
Phone Type 3
Phone3
Street Address
City, St and Zip
Emergency Contant or another Parent/Guardian Information (only need one or the other, not both)
Parent/Guardian 2
Parent/Guardian 2
Parent/Guardian Email 2
Parent/Guardian Phone 2
Work Phone
Home Address
City, State and Zip

Emergency Contact
Emergency Contact Name
Emergency Contact Phone Number
Emergency Contact Work Phone
Emergency Contact Address
City State Zip

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