Building for the Future Conference - Southwestern College

2024 Building for the Future

International Conference

Please mark your calendars for July 11 to July 14, 2024, for a weekend of fellowship and worship on the campus of Southwestern College in Winfield, Kansas. The event promises to be a lot of fun!

To register, please complete the form below. Guests are invited to arrive prior to dinner on July 11 and check-out on the morning of July 14.

Conference Registration
The conference registration fee is $150 per person. Registration Fees will include T-shirts and lunch/dinner on Friday and Saturday. (Breakfast will be at Quality Inn and Suites each morning. Lunch and Dinner will be provided by Fresh Ideas at Southwestern College). For Attendees that come on Thursday, July 11, dinner will be on your own at a local restaurant. The program will start at 8:30 am on Friday, July 12 in Messenger Recital Hall on Southwestern College's Campus.

Hotel Accommodations
All attendees will need to make their own hotel accommodations at Quality Inn and Suites, 3800 S Pike Rd, Winfield, KS by calling 620-221-7529 and telling them you are with the Building for the Future Conference to receive the discount. To get the discount reservations must be made by June 28, 2024. Attendees are encouraged to check in on Thursday, July 11, and check out on Sunday, July 14.

Visa Information
For more information on how to obtain a Visa please visit, https://travel.state.gov/content/travel/en/us-visas.html

Registration deadline is June 28, 2024.
Attendee Information
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone*

Area CodePhone Number
E-mail*
Your T-Shirt Size*
Do you need an invitation letter for visa purposes?

YesNo
IMPORTANT: A $50 non-refundable fee is required for anyone who requires a visa. Be sure to include it in the payment section below.
Food allergies or dietary restrictions (if any)
List all attending with you
Health Information

If you have medical insurance, your carrier will be billed for medical charges in the case of illness or injury while your child is at the activity.

If your child should require medical attention for injuries received or illnesses contracted prior to activity, please send us the necessary information to give him/her proper medical care during his/her time at Southwestern College.
Do you have Health Insurance?*

YesNo
Name of Insurance Company*
Policy Holder's Name*

First NameLast Name
Primary Physician's Name*

First NameLast Name
Primary Physician's Phone*

Area CodePhone Number
Pre-existing or present medical conditions:
Name and dosage of any medications that must be taken:
Any Allergies (including food or medication):

Hay feverHeart conditionDiabetesInsect stingsAsthmaPhysical handicapEpilepsy/nervous disordersFrequent stomach upsetsAny major illnesses during the past yearOther
If any of the above is checked, please give details (i.e., include normal treatment of allergic reactions):
Parent Medical and Liability Release Statement (all checkboxes are required)*

I understand that in the event medical intervention is needed, every attempt will be made to contact immediately the persons listed on this form. In the event I cannot be reached in an emergency during the activity dates shown on this form, I hereby give my permission to the physician or dentist selected by Southwestern College to hospitalize, to secure medical treatment, and/or to order an injection, anesthesia. or surgery for my child as deemed necessary.I understand that my insurance coverage for my child will be used in the event medical intervention is needed and that I am responsible for the payment of any/and all medical services.I understand all reasonable safety precautions will be taken at all times by Southwestern College and its agents during the events and activities.I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Southwestern College, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the undersigned.
Payment & Attendance
Payment method*

Online with credit cardMail via check
Payment via Mail/Check
Building for the Future Conference Registration - $150/person
Housing & Meals
Number of People Staying - Th-Sat
(including yourself)
Number of People Staying - Fri-Sat
(including yourself)
Number of People Staying - Sat
(including yourself)
Meals Only
Number of People Dining
(including yourself)
Number of People Dining - Fri-Sat
(including yourself)
Visa Letter

$50 Non-refundable fee
Total Due $
Payment can be made by mailing check to:

Brittany Donals
Director of Camps & Conferences
Southwestern College
100 College St.
Winfield, KS 67156-2499

Any checks should be made payable to Southwestern College - Building for the Future. Questions, please contact Brittany Donals at 620-229-6141.
Payment via Online/Credit Card

Check the boxes next to the items you want to add to your cart, then mark the number of each who will attend.

Will you be staying in On-Campus Housing?*

YesNo
Campus Housing

(Only fill out if staying overnight on campus.)
Estimated day of arrival*

ThursdayFriday
Estimated time of arrival*

:HourMinutesAM/PM Option
Number of people staying overnight on campus (including yourself)*
I would like to request a roommate
(Type full name)
Waivers & Policies
Signature

I hereby acknowledge that I have read, understand, and will abide by each of the terms and conditions of this Agreement. I understand that I may seek legal counsel of my own choosing to fully explain any terms of this Agreement to me before I sign it.
Signature*
Enter the message as it's shown*
Should be Empty:

Attendee Information

Payment & Attendance

Payment via Mail/Check

Campus Housing

Waivers & Policies

Signature