PURSUIT - NOV. 22-23, 2024

PARTICIPANT INFORMATION

Name:*

First Name (Nombre) Last Name (Apellido)

Age:*

(Edad)

Check one:*

MaleFemale

Phone Number: *

(Numero Telefonico)

Location:*

Street Address (Direccion)

Street Address Line 2

City (Cuidad)State (Estado)

Email Address:*

(Correo Electronico)

Church Name:*

(Nombre de Iglesia)

Please read the following note and check below, acknowledging that you read and understand it: Because we are gathering at a church for Pursuit this year, (Cathedral of Faith - 1349 Stonewall St, San Antonio, TX 78211), we will not be able to provide overnight lodging. Each young adult will have to arrange his/her own lodging accommodations, (i.e. hotel, Airbnb, friends/family, etc.)*

I have read and understand this note

Your registration includes a T-shirt, (for registration forms submitted up to November 16th, 2024). We cannot guarantee a shirt for registrations submitted after that day. What size would be best for you?

HEALTH INFORMATION

Emergency Contact:*

First Name (Nombre) Last Name (Apellido)

Relationship to Participant:*

(relacion con el participante)

Phone Number: *

(Numero Telefonico)

Please list any allergies (including food allergies):

(Indique caulquier alergia incluidas las alergias alimentarias)

LIABILITY RELEASE FORM

As a legal adult or parent/guardian of the above, I do hereby release, forever discharge and agree to hold harmless Youth United For Christ of Unified Pentecostal Local Church Int'l, Inc., and the directors thereof from any and all liability claims or demands for personal injury, sickness, or death, as well as property damages and expenses of any nature whatsoever which may be incurred by the undersigned and participant that occur while said person is participating in the above described event, and it's activities including recreational activities. The undersigned hereby agree to hold harmless and indemnify said church/group, its director's sustained by said acts of said participants, including expenses incurred attendant thereto.
The undersigned further consents to the administration of first-aid and/or doctor's care, or any other form of medical treatment necessitated by illness or injury that may require the same. In the event of the necessity of such are or treatment described, the undersigned agrees to indemnify said church, its directors, and agents from any acts of malfeasance, and/or failure to act on the part or those chosen to administer medical care on behalf of the participant.

Participant's Signature:*

(Firma del participante)

Your online registration is not complete until you have committed to pay the event registration fee. You may submit the registration fee of $40.00 via online giving (Vanco), mail-in, or onsite at Cathedral of Faith in San Antonio, Tx. PLEASE check the following option as an assurance that you have done this:*

I have paid $40.00 on or before November 22nd, 2024 via Vanco at uplciiyufc.com -> "online giving" -> "Pursuit 2024"I have sent $40.00 in the form of cash or a check before November 22nd, 2024 via mail to P.O. Box 4082 Beeville, Tx 78104.I will pay $40.00 on November 22nd, 2024 onsite at Cathedral of Faith in San Antonio, Tx.