MUUUCE 2024 Adult Registration Form

MUUUCE stands for the Most Unbelievable, Ultimate, Urban(ish) Camping Experience. This incredible event is designed specifically with Northwest Conference middle schoolers in mind. It’s three days of crazy middle school fun, woven with worship experiences, challenging talks, and small group conversations!

This year's MUUUCE will include a trip to Valley Fair amusement park. Leaders should ask the point person at their church to find out the cost of MUUUCE, including any money they need to bring for incidentals. Many of the meals will be provided at MUUUCE.

QUALIFICATIONS

Leaders must be at least 18 years of age by August 4, 2024 & have graduated from high school & have an approved background check.

MUUUCE requires criminal background checks for every adult serving at MUUUCE. Background checks must be no older than August 4, 2022. Please let your MUUUCE leader or church administrator know immediately if you have not completed a background check or if your background check is more than two years old. Your registration will not be complete until MUUUCE confirms a current background check.

Compliance with the following standards of conduct is expected of all leaders & participants at MUUUCE. If you fail to comply, you may be sent home at your own expense:
o   Use &/or possession of alcohol &/or other controlled substances, fireworks, firearms, or other dangerous weapons (e.g. knives, slingshots, laser pointers, etc.) during MUUUCE is prohibited.
o   Individuals are liable (& will be billed) for any damage they intentionally or accidentally commit to Buffalo Covenant or to MUUUCE property.
o   All students are under the supervision of their respective church leaders.
o   Quiet hours are to be observed (no music, yelling, cheerleading, etc.).
o   Smoking, chewing tobacco, or vaping are not permitted at MUUUCE.

Leader's Name

First NameLast Name

Birth Date

MonthDayYear

Gender

MaleFemale

Church Registering with (Including City/Town)

Please include the location of your church. For example: Salem Duluth vs Salem New Brighton vs Salem Pennock. This church is what's referred to as the "Sponsor Church" in the Informed Event & Medical Consent and Acknowledgement section below.

Email

example@example.com

Phone Number

Please enter a valid phone number.

Please add me to the Group Text for Adult Leaders at MUUUCE. This is primarily used at the event (we might send a text or two before or after the event).

Yes, please add my numberNo, don't add me to the text group. I understand that I may miss out on valuable notices.

T-shirt Size (based on men's t-shirt sizes)

Valley Fair

Check this box if you have a season pass to Valley Fair.

Leader Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Information

Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Email

example@example.com

Medical Information

Insurance Company

Insurance Policy #

Do you have any allergies, including food allergies? If yes, please describe. If you have any dietary restrictions, please email MUUUCE@northwestconference.org by August 1 to discuss the available dietary options. Unfortunately, we cannot make dietary accommodations once the event has started.

Do you have any chronic illness, or medical conditions, including mental health issues? If yes, please describe.

Do you have any sensory or sleep issues? If so, please describe. We will do our best to help create an environment that is comfortable for you, but please understand that this is a loud, crowded event and participants sleep on the church floor.

Are you prescribed an inhaler? If yes, please explain any instructions.

List any other information that an EMT or attending physician needs to be aware of:

Informed Event & Medical Consent and Acknowledgement

MUUUCE ADULT CONSENT & MEDICAL FORM
Please read and sign the statement below. This provides permission to seek whatever medical attention maybe necessary. It also releases Northwest Conference of the Covenant Church (NWC), Buffalo Covenant Church (BCC), and / or the church's personnel from any liability against personal injury or loss.

I understand the arrangements and believe that necessary precautions and plans for the care of participants will be taken during this event. By participating in any and all MUUUCE activities prepared by the Northwest Conference of the Covenant (hereafter referred to as NWC), Buffalo Covenant Church (hereafter referred to as BCC), and my sponsoring church (hereafter referred to as "Sponsor Church") to, from, and during MUUUCE, I assume all risk and hazards incidental to the conduct of the activities. I release, absolve and hold harmless the NWC, BCC, and Sponsor Church and all its respective officers, agents, and representatives from any and all liability for injuries arising out of traveling to, participating in, or returning from MUUUCE.

In case of emergency, I hereby give the MUUUCE leadership, staff or other emergency medical personnel the permission to seek emergency medical treatment in the event that such treatment is deemed necessary by the conference or church staff. I give permission to those administering emergency medical treatment to do so using those measures deemed necessary. I absolve the NWC, BCC and Sponsor Church and/or church personnel from liability in acting on my behalf in this regard, so long as they are not grossly negligent.

Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Date

Signature

MUUUCE Adult Leader Form

Included: 1) Registration Info, 2) Informed Event & Medical Consent and Acknowledgement Form

Leader's Information