Register for Freedom Challenge 2017 Please complete this form to register and order your resources for Freedom Challenge Question Title * 1. Name of Youth Group / School Question Title * 2. Number of members in your group? 5-11 11-20 21-50 76-100 101+ Question Title * 3. Postal Address of School Name Address Address 2 City/Town ZIP/Postal Code Question Title * 4. Teacher Coordinator Details Name Email Address Question Title * 5. Student Coordinator Details Name Email Address Phone Number USE OF PHOTO PERMISSIONI give Amnesty International permission to use my photograph and details for future promotional activity (i.e. newsletters, publications, social media, website, videos). I also give permission to Amnesty International to release my photograph to third parties (i.e. newspapers, television networks) Question Title * 6. Photo permission Yes No YOUR RESOURCE REQUIREMENTSWe will do our best to meet the numbers that you request, but please note we do have limited supplies of all resources. Question Title * 7. How many Amnesty International badges do you require? 0 50 100 150 200 Question Title * 8. How many Amnesty International stickers do you require? 0 50 100 200 Done