2024 MUUUCE Student Registration Form

MUUUCE Student Forms
Included: 1) Registration Info, 2) Informed Event & Medical Consent and Acknowledgement Form and 3) Student Conduct 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. Participants should ask their youth leader 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.

MUUUCE is a ministry of the Northwest Conference of the Evangelical Covenant Church.
Student Information
Student's Name

First NameLast Name
Birth Date

MonthDayYear
Grade Entering in Fall 2024
Gender

MaleFemale
NWC 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.
T-shirt Size (based on men's t-shirt sizes)
Valley Fair

I have a season pass to Valley Fair. (This will reduce your MUUUCE fee by $25.)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Parent/Guardian Information
Name

First NameLast Name
Phone Number
E-mail
example@example.com
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number
Medical Information
Insurance Company
Insurance Policy #
Does the participant have any allergies, including food allergies? If yes, please describe. If your student has 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.
Does the participant have any chronic illness, or medical conditions, including mental health issues? If yes, please describe.
Does the participant have any sensory or sleep issues? If so, please describe. We will do our best to help create an environment that is comfortable for them, but please understand that this is a loud, crowded event and participants sleep on the church floor.
Is the participant prescribed an inhaler? If yes, please explain any instructions.
List any other information about this person that an EMT or attending physician needs to be aware of:
Informed Event & Medical Consent and Acknowledgement

Parents/Guardians please read and sign the statement below. This provides permission to seek whatever medical attention may be necessary. It also releases the Northwest Conference of the Evangelical Covenant Church (NWC), Buffalo Covenant Church (BCC), and/or the church's personnel from any liability against personal injury or loss.

I hereby give my approval for my child’s participation in any and all activities prepared by the Northwest Conference of the Evangelical Covenant Church (hereafter referred to as NWC), Buffalo Covenant Church (hereafter referred to as BCC), and the child's sponsoring church (hereafter referred to as "Sponsor Church") to, from, and during MUUUCE. In exchange for the attendance of said child in MUUUCE, I assume all risk and hazards incidental to the conduct of the activities, and 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 to said child arising out of traveling to, participating in, or returning from MUUUCE.

In case of emergency, I understand that every effort will be made to contact me. If I cannot be reached, I hereby give the MUUUCE leadership, staff or other emergency medical personnel the permission to act on my behalf in seeking emergency medical treatment for this child 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

MonthDayYear
Date
Signature

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MUUUCE STANDARDS OF STUDENT CONDUCT
Student Signature Required

I commit to fully engage in the programming during MUUUCE.

This will require that I adhere to the following Standards of Personal Conduct:

I will:
1.    Abide by all rules and expectations of MUUUCE and my church.
2.    Actively demonstrate the values of safety, responsibility, and respect.
3.    Fully engage with positive participation in all activities and discussions.
4.    Observe Quiet Hours (no music, yelling, cheerleading, etc.).

I will not:
· Engage in any behavior that may be disrespectful or harmful to the health and safety of the participant or others, including bullying or harassment.
· Possess, use, or consume: illegal drugs, alcoholic beverages, or tobacco, including vaping.
· Use or possess fireworks, firearms, or other dangerous weapons (e.g., knives, slingshots, laser pointers, etc.).

I understand that:
· Individuals are liable (& will be billed) for any damage they intentionally or accidentally commit to Buffalo Covenant, MUUUCE property, or any other business/venue visited during MUUUCE.
· All students are under the supervision of their respective church leaders.
· Leaders have the right to confiscate any items used abusively by students for the duration of MUUUCE.

Any infraction or disregard for the Standards of Personal Conduct may result in my immediate dismissal from MUUUCE. I acknowledge that I may be sent home from MUUUCE at my own expense.
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.
Student Signature

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MUUUCE Student Forms

Included: 1) Registration Info, 2) Informed Event & Medical Consent and Acknowledgement Form and 3) Student Conduct Form

Student Information