Deco-TEC REGISTRATION FORM

Name*

Address*

City*

State*

Zip*

Phone*

E mail Address*

example@example.com

School*

Grade*

Birthday MM/DY/YR*

Gender*

MaleFemale

Age at time of weekend*

Home Church

Who invited you to come*

Sponsor's email*

example@example.com

Parent Name (s)*

Address*

Address (if different )

Street Address Line 2

City, State, Zip

Phone*

Emergency Contact*

Phone Number*

Allergies and/or Dietary Restrictions*

Health Problems that would affect the weekend*

Does your child have any regularly scheduled medications?*

YesNo

If "yes," please give us names and times for medication.

Is it allowed for an adult team member to give over the counter medications?*

YesNo

Do you give permission to share your name, address & phone number with the DecoTEC Community?*

YesNo

Parental Consent to Treat: "I hereby consent that my son or daughter be able to participate in a DecoTEC weekend. I indemnify, defend, and hold harmless DecoTEC and all youth leaders from all claims made and liabilities assessed against them as a result of all the activities. Furthermore, in case of an emergency, I understand that every effort will be made to contact the parents or guardians of a minor child. However, if parents or guardians can't be reached, I hereby give DecoTEC leaders permission to act on my behalf in seeking medical treatment in the event that such treatment is deemed necessary or advisable for the child's health and welfare. I give permission to those administering medical treatment to do so, using the measures deemed necessary. I release DecoTEC, DecoTEC leaders, and all medical providers from liability for acting on my behalf in this regard and rendering such medical treatment. I assume the risk and financial responsibility for any injury resulting from the child's activities."

PARENT'S SIGNATURE*

PRINT NAME*

DATE*

Date

To enable youth to experience the presence of Christ. His presence becomes a living reality as the participants grow into a Christian community during the weekend.

In DecoTEC, you experience

A fresh atmosphere away from home, church, and school

Meeting young men and women from schools throughout the area.

Reflecting and sharing with others how you see yourself, your ideas, hopes, and problems.

Finding a God you can believe in and encountering Jesus Christ alive today and forever.

The team for a DecoTEC weekend is composed of all elements: married and single adults, teens, ministers, and youth ministers. All portraying, through their tasks and their presence, the living reality of Christ in our lives.

The weekend revolves around people and the world we live in, offering small group experiences, liturgy, music, and good food in a relaxed atmosphere.

The growth experience on a DecoTEC weekend affects and benefits all who participate, including team members as well as candidates.

By clicking "Yes", I have read and understand the goals of DecoTEC*

YesNoCall me

Deco-TEC Registration, Judy Lynn O'Neill 29716 Follmer St, Niles, MI 49120 email to: Decotec.michiana@gmail.com

Registration Fee: $40.00 can be paid online below.

The weekends can't go on without these small gifts. Checks should be made out to DecoTEC if they are paid the night of check-in. If there is a problem with the donation, please get in touch with us. Don't let the cost of getting to DecoTEC stop you! Attendance on the weekends is based on "first come, first served." Submit the application form right away. Space is limited. You will be informed if your application was accepted and any weekend info.

Pay Online

Teen Weekend Fee'sCovers food and supplies

$40.00 Quantity

Total

$0.00

MEDICAL RELEASE INFORMATION

The Goal of DecoTEC