HLVYth Conference Student Registration

HLVYth Conference Student Registration

Please book for your conference by filling the form below.
Student's Full Name*

First NameLast Name
Sex*

MaleFemale
Grade*
Birthday*

MonthDayYear
Date
Parent/Legal Guardian 1*

First NameLast Name
Parent/Legal Guardian 2

First NameLast Name
E-mail*
example@example.com
Phone Number*
Church Affiliation*
I do hereby on this blanks* day of blank* 2024, give my permission for my child, First Name* Last Name* to take part in HLVYth Conference including activities such as, but not limited to group games, individual activities, and Christian spiritual services hosted by Harvest Life Victory Church Youth Group from November 15 to November 16, 2024.

I understand in the event of a serious illness or accident, reasonable efforts to
reach parent/legal guardian/s or emergency contact will be made, whether by Conference volunteers/staff or the student’s youth group leader.

I recognize it is a privilege for my child to participate in this conference and I do hereby hold Harvest Life Victory Church, Harvest Life Victory Youth, their directors, employees, and all volunteer leaders involved indemnified from any and all liability whatsoever, which may arise because of, or in connection with this conference. I understand the risk of activities and give my consent for my child to participate in all activities that the HLVYth Conference entails. I hereby release all parties previously mentioned from any necessary medical cost.

Should any situation occur involving any kind of abuse or perceived abuse by a leader not affiliated with Harvest Life Victory Church, I do hereby agree to hold Harvest Life Victory Church, Harvest Life Victory Youth, their directors, employees, and all volunteer leaders, harmless from any and all present and future liability, actions, causes of actions, claims, expenses, and damages on account of injury, including death, to my child or property.
Emergency Contact*
Emergency Contact Phone Number*
Current Medical Conditions: (Include nature of any required attention, special needs, diseases, physical/mental limitation, medical conditions, and/or allergies to medication and otherwise.)*
By signing this, you, the parent/guardian, are acknowledging that you have read and agree to all terms and conditions and have been honest in each field stated thus far in this form.*

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I, blanks* , hereby grant to Harvest Life Victory Church, their successors, and their assignees the right to record the image and/or voice and use the artwork and/ or written work of my child, blank* , on video, on film, on photographs, in digital media, and in any other form of electronic or print medium and to edit such recording at their discretion.

I understand that my child's full name, address and biographical information will not be made public. I further grant Harvest Life Victory Church, their successors, and their assignees the right to use, and to allow others to use, my child's image and/or voice on the internet, in brochures, and in any other medium and hereby consent to such use.

I hereby release Harvest Life Victory Church, their successors, and their assignees using my child's image and/or voice, artwork, and/or written work pursuant to this media release form from any and all claims, damages, liabilities, costs, and expenses which I or my child now have or may hereafter have by reason of any use thereof. I understand that the provisions of this release are legally binding. Please check one:
I consentI do not consent
Name of Parent/Guardian*
Parent/Guardian Signature*

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Date*

MonthDayYear
Date
Conference Workshop Sign-up
Morning Workshops

Mastering the Inner Storm: A Guide To Your ProcessSharing Your Faith As A TeenWhat Is The Bible For?
Optional Late Afternoon Workshops

The Heart of Leading WorshipNextGen Ministry (Children's min)Walking in Your Calling To Ministry*Check this box if you will not be attending a ministry workshop
All payments for HLVYth Conference are to be submitted by e-Transfer or cash before or upon arrival.
Please choose method of payment*

$30 cash upon arrival$30 E-transfer payable to church@hlvc.org (Message: "Conference")
Payments are processed through PayPal. You may pay using an existing PayPal account, or any major credit card / debit card.
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HLVYth Conference Student Registration

Conference Workshop Sign-up

All payments for HLVYth Conference are to be submitted by e-Transfer or cash before or upon arrival.