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  • Insurance Info

  • Health History

  • All attendees are expected to participate, not spectate, in ALL activities provided for them while at NYC. If you have a medical illness or injury that would hinder you from participating in any activities, please send us the necessary information to avoid further issues.

  • Emergency Contact Info

  • Pastor Recommendation

  • By signing below I understand:

      The District NYC Coordinator and/or NYI Council will make the final decision on what sponsors will be able to attend.


      I MUST be 23 years old by time of the event to participate. This excludes those on staff at the local church.


      I need an up to date Photo ID before the trip and a copy will be sent with this form.


      My Ministry/Naz Safe and Background Check are up to date (conducted within 2 years of the event) and a copy will be sent with this form.


      The Pastor Recommendation section of this form must be filled out to be considered as a sponsor.


      Registration will be online and an email will be sent to complete registration.

     

     I understand that if I have filled out this form for the early bird price, but fail to register on planning center before October 15th, 2022, an extra charge of $75 will be added to my sign up.


      Payments are to be made on time (refer to payment schedule below). Failure to do so could result in not participating.


      Money is not refundable due to pre-purchasing and ordering of items (flights, conference costs, hotel costs, etc.).

     

      Each church can bring 1 adult per 7 students they have going on the trip. I am aware that not every adult who applies will be permitted to attend.

     

      Some churches may not send an adult with their students. I understand that I may be in charge of students that might not be from my church while on the trip.

  • Due to the complex problems we face in today’s world, we need a signed statement from you in answer to the following question. Insurance companies request that church groups, as well as other groups, follow this procedure to eliminate charges against our district or church related programs.

  • I certify that the answer set forth above is complete, true, and honest, to the best of my knowledge. I hereby grant my permission for the investigation of the statement set forth herein, in a reasonable manner, to determine my qualifications for service. I recognize that under no circumstances is this a contract for employment. I further recognize that any false or misleading statements made here, or made verbally to my superior, if any, may be grounds for discharge. I understand and agree to abide by all rules, regulations, and directions of my superior. I am fully aware that my responsibility as an adult sponsor while at NYC is to positively promote Christ, NYC, adult leadership, and student participants at all times. I understand that my act of service is to be the model example in following any and all guidelines provided by the District NYC Director and NYC Leadership. With that, I agree to monitor my cell phone and electronic usage as I set the best example to the student participants at NYC. I believe and want to enhance safety, limit distractions, and promote spiritual development the best I can by interacting with other adult sponsors, District NYC Leadership, and most importantly, student participants. I have read, understand, and agree to abide by the above statements while fully agreeing to set a positive example to all while at Nazarene Youth Conference 2023.
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