Teen Renovation Registration Form

We are so glad that you are thinking about registering for Teen Renovation! We believe that this 5-day training has the potential to be one of the best investments you have ever made in yourself.

Please complete all three pages of this registration form. A parent/guardian signature is required. An email confirmation with further details will be sent to you within 2-3 business days. Registration fees can be paid online at the end of this form, or you can send us a check in the mail.

There are only 24 spots available per training. Please complete the registration form and payment as soon as possible.
Student Information | Pg. 1
Name

First NameLast Name
High School Attending
I acknowledge that I must be 15-19 years of age in order to attend this training
I acknowledge that I will be available for the full training. (June 26th-30th.)
Grade
Age
Birth Date
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Select your T-shirt size here.
Parent Information
Father/Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Mother/Guardian Name

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Please verify that you are human

Medical & Liability Release Form | Pg. 2
Participants Name

First NameLast Name
Birth Date
Describe your overall health and names of any medications you are taking
Please list any medical needs, conditions, or allergies:
Insurance Company’s Name (Please type N/A if the teen does not have health insurance)
Policy Number
Group Number
Insurance Phone Number

Area CodePhone Number
I give my permission for the below minor to participate in Teen Renovation hosted by the Renovation Group Ministries, LLC. All activities and events sponsored by Renovation Group Ministries, in the event of an emergency where medical treatment is required; I give permission to the staff and/or adult leadership to obtain the services of a licensed physician. In the event medical treatment for injury or illness becomes necessary, I and/or my personal insurance will be responsible for costs incurred. I acknowledge that I am (we are) freely and voluntarily participating in any activity associated Renovation Group Ministries, Event/s. I (we) fully acknowledge that there are risks inherent with Renovation Group Ministries, LLC, activities, including but not limited to sports, team games, exercises, and other outdoor activities, and I (we) hereby assume all responsibility for any losses and/or damages, to myself, whether caused in whole or in part by myself or others; I (we) fully understand and appreciate the hazards and risks of the aforementioned activities and I am (we are) willing to accept all the hazards associated with this event. I (we) on behalf of my personal representative, my heirs, and myself voluntarily agree to release, waive, discharge, hold harmless, and indemnify the officers, directors, members, volunteers, employees, agents, or leadership of Renovation Group Ministries from any and all liability or claims in the event of injury, death, or property damage to myself or others from any cause during my participation in this event. I (we) specifically understand that I am (we are) releasing, discharging and waiving my claims or actions that I (we) may have presently or in the future for the negligent acts or other conduct by the owners, agents, officers, and volunteer of Renovation Group Ministries I (we) have read the above waiver and release, and by signing it agree to its terms. It is my intention to exempt and relieve Renovation Group Ministries, LLC and individuals from liability for personal injury, property damage or wrongful death caused by negligence or other cause.
I / We the undersigned do hereby give permission to Renovation Ministries, LLC representatives to obtain any necessary medical treatment for the person named above during the conduct of this Teen Renovation training on the dates of:
Training Dates
Participant
Parent/Guardian
Emergency Phone Number 1:

Area CodePhone Number
Emergency Phone Number 2:

Area CodePhone Number

Registration Payment Options
How would you like to pay your registration fee?
Payments By Mail
Checks must be received within two weeks of submitting your registration form
Full Scholarship
Please enter the code you were given for your full scholarship.
Payments By Card
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Student Information | Pg. 1

Parent Information

Medical & Liability Release Form | Pg. 2

Participant Intake Form | Pg. 3

Registration Payment Options

Payments By Mail

Full Scholarship

Payments By Card

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