UNITE Registration May 2, 2026

1

Student Name* This field is required.Who will be joining us for UNITE?

First

Last

2

Any Health Concerns?Does your child have any allergies we should be aware of? Food intolerances? Medications we need to know about?

3

Healthcare Number?Totally optional. If you would like us to have their healthcare number in case of emergency, add it here! Note that you will be contacted in case of emergency whether we have their healthcare number or not.

4

Anyone else?* This field is required.Are there any other siblings you are registering at the same time?

YES NO

5

Student NameWho will be joining us for UNITE?

First

Last

6

Any Health Concerns?Does your child have any allergies we should be aware of? Food intolerances? Medications we need to know about?

7

Healthcare Number?Totally optional. If you would like us to have their healthcare number in case of emergency, add it here! Note that you will be contacted in case of emergency whether we have their healthcare number or not.

8

Anyone else?Are there any other siblings you are registering at the same time?

YES NO

9

Student NameWho will be joining us for UNITE?

First

Last

10

Any Health Concerns?Does your child have any allergies we should be aware of? Food intolerances? Medications we need to know about?

11

Healthcare Number?Totally optional. If you would like us to have their healthcare number in case of emergency, add it here! Note that you will be contacted in case of emergency whether we have their healthcare number or not.

12

Anyone else?Are there any other siblings you are registering at the same time?

YES NO

13

Student NameWho will be joining us for UNITE?

First

Last

14

Any Health Concerns?Does your child have any allergies we should be aware of? Food intolerances? Medications we need to know about?

15

Healthcare Number?Totally optional. If you would like us to have their healthcare number in case of emergency, add it here! Note that you will be contacted in case of emergency whether we have their healthcare number or not.

16

Who are you?* This field is required.Who is giving permission for the student(s) previously mentioned to attend UNITE?

First Name

Last Name

18

How can we reach you?* This field is required.In case of emergency, what number should we call?

(xxx) xxx-xxxx

19

What's your Email?* This field is required.We may need to send you some important information, or just some reminders regarding UNITE beforehand.

example@something.com

20

Payment* This field is required.We ask that you pay for the Youth Rally through your local church. You should hear from your Youth Pastor shortly, or if you don't have one, expect an email from Pastor Karter in Bonnyville. The base cost of the Youth Rally is $20, however, if you are from outside Bonnyville and will be travelling with your group (i.e. on a bus) there may be an extra fee associated which will be added into your total charge.

I understand the above statement.

21

Sign here...* This field is required.By signing this form, you agree that you are the parent/guardian of the student(s) listed on this form. You agree to hold blameless Lakeview Gospel Centre, as well as any other parenting churches for any injury that may occur throughout the day, as well as granting permission for your child(ren) to attend the UNITE Youth Rally on May 2nd, in Bonnyville. If applicable, signing this form also agrees to allow your child(ren) to travel with your Youth group, understanding that the method of transportation will be communicated by your local Youth Pastor or Youth Leader. If travel is a part of your day for UNITE, signing this page states that you agree to hold blameless the church that you travel with in case of incident. By Signing this form, you are agreeing that you are a parent/guardian to the child(ren) listed on this form, and that you are granting permission and a waiver of liability regarding the above statements.