Lynchburg Chinese Christian Conference 2025 Registration

- 2025 年林奇堡中國基督徒退修會報名表 - Lynchburg Conference 2025 Online Registration
Registration has moved online this year! Complete ONE (1) form per family. If family members are staying in different housing (e.g., 3 people in lodge, 2 people in hotel), then please complete separate forms.

Registration forms are due by Wednesday, May 7th, 2025 (Early Bird registration rate available until 5/7/25 11:59pm). College student discount ($20 off/student) available until Saturday, April 12th, 2025, 11:59pm.

Payment will be collected by each individual church (through the "Conference Point of Contact"). There is NO online payment option. Please send your payment to your church's Conference Point of Contact. Completion of this form does not guarantee you a room until payment is collected.
The registration fee includes meals and lodging.

Please email Hannah Chen (hannahchen@gmail.com) or Xing Huang (xing11806@gmail.com) if you have any questions.

For information on this year's theme and speakers, visit: https://lynchburgconference.org/

今年請大家在網上註冊，每個家庭填一張表。如果家庭成員有不同的居住要求（比如3人住宿舍，2人住旅館），請分別填寫不同的表格。

報名截止時間是2025年五月7日，星期三（當晚11:59pm之前報名費有優惠）。大學生優惠（每人减$20）截止在2025年四月12日11:59pm。

費用由地方教會收集（通過“大會聯絡人”）。沒有網上付費方式。請將費用交給您教會的大會聯絡人。在收到費用之前，填寫本表格並不能保障您有房間。
註冊費包括食宿。

若有問題，請諮詢陳佳(Hannah)姊妹(hannahchen@gmail.com)或黃永星弟兄(xing11806@gmail.com)。

關於今年的大會主題和講員，請參訪 https://lynchburgconference.org/
主要註冊聯繫人 Primary Registration Contact*

名 First Name姓 Last Name
電信 Email*
Phone*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
所屬教會 Name of church you are registering with (the church Conference Point of Contact will collect your registration fee):*
Church/Group Name if "Other"*
教會城市, 州 Church city, state*
緊急聯係人 Emergency Contact*

名 First Name姓 Last Name
電話 Emergency Contact Phone*
Please enter a valid phone number.

個人資料 Individual Attendee Information (list each attendee, including yourself) [phone users- scroll right for all 6 columns. 用手機報名者請向右滑動，填寫全部6個欄目。]*

	(1/6) 名 First Name	(2/6) 姓 Last Name	(3/6) 性別Gender	(4/6) 參加選擇Session (Chinese, English, Children)	(5/6) 年級School Grade / College Year for 2024-2025	(6/6) 年齡 Age (if under 18)
Attendee 1
Attendee 2
Attendee 3
Attendee 4
Attendee 5
Attendee 6

膳食 - 為節省大會開支請確實填寫成人及二到八歲兒童人數 Conference Meals - To help with meal planning, please indicate the number of Adults & Children (ages 2‐8) for each meal:*

	Total number of Adults (成人)	Total number of Children (兒童)
星期五 - 晚 Friday Dinner
星期六 - 早 Saturday Breakfast
星期六 - 中 Saturday Lunch
星期六 - 晚 Saturday Dinner
星期日 - 早 Sunday Breakfast
星期日 - 中 Sunday Lunch
星期日 - 晚 Sunday Dinner
星期一 - 早 Monday Breakfast
星期一 - 中 Monday Lunch

Conference Housing (住宿 )*

Church Lodge ($190/person) [ 宿舍 ]Hotel ($390/person) - Hotel rooms are reserved only for special cases. All hotel requests require approval from hotel coordinator based on reason and availability. [ 旅館 - 旅館房間僅爲特殊情況者保留。所有旅館申請皆需大會旅館協調員根據理由和供需狀況審批。]Family Friendly Plan Registration (Hotel or Lodge) - Financial assistance for young families. Requires coordinator approval after submitting. [ 家庭照顧項目註冊表. 需要協調員審批 ]Leaders' Lodge (only for EM small group leaders or coordinators)No Housing (only for Lynchburg residents) [ 不需住宿（僅限於林城居民）]
Reason For Requesting Hotel - Completing this form will automatically submit your hotel request to the Hotel Coordinator. You will receive a response email within a few days. (申請旅館理由——若填寫此表，您的申請會被交予旅館協調員。您會在數日內收到答覆的電子郵件。)*

Over 65 (65歲以上)Medical Condition (健康狀況)Caretaker of person over 65 or with medical condition (65歲以上有健康狀況者的照顧人)Conference/Workshop Speaker or Coordinator (講員或協調員)
Any other information related to your hotel request (與旅館申請相關的其他資訊) :
Today's Date

MonthDayYear

Family Friendly Plan is available for young families who need financial assistance. Families may qualify if they have 3 or more children all under the age of 18. Families with one child under 3 years old may also qualify for assistance. There is a limited amount of conference funding available for this plan. First come first serve. Completing this registration form will automatically submit your application to the Family Friendly Plan coordinator. You will receive a response in 2-3 days.

家庭照顧項目是爲着需要財務幫助的年輕家庭而設。優先考量有三個（或更多的）18歲以下的子女的家庭，有一個3歲以下兒童的家庭亦可考慮照顧。大會用於該項目的資金有限，根據申請時間先後審批。若填寫此表，您的申請會被交予家庭照顧項目協調員，2-3日後答覆。
Any other information related to your Family Friendly Plan request (與申請家庭照顧相關的任何其他信):
您註冊了幾位大學生？How many college students are you registering? ($20 discount if before April 13)
報名費總數 Total Registration Fee (give to your church's Conference Point of Contact)
Make checks payable to “Mid‐Atlantic Chinese Christian Conference Inc” or “MACCC”.
Please include the name of the "Primary registration contact" on your check.

(A copy of this form will be emailed to you after you complete registration.)

支票請寫給 “Mid‐Atlantic Chinese Christian Conference, Inc” 或 “MACCC”.
請在支票上標明“主要註冊聯繫人”的名字。

（在您完成註冊後我們將把該表副本電郵給您。）

	人數 How many total?
Adult Attendees (age 10+) - $190 / person [大人（10歲以上) - 每人$190]
Child Attendees (age 3-9 years) - $95 / person [兒童（3-9歲) - 每人$95]
Infant (0-2 years old) - $0 / person [嬰孩（0-2歲) - 免費 ]

	人數 How many total?
Adult Attendees (age 10+) - $200 / person [大人（10歲以上) - 每人$200]
Child Attendees (age 3-9 years) - $100 / person [兒童（3-9歲) - 每人$100]
Infant (0-2 years old) - $0 / person [嬰孩（0-2歲) - 免費 ]

	人數 How many total?
Adult Attendees (age 10+) [大人（10歲以上)]
Child Attendees (age 3-9 years) [兒童（3-9歲)]
Infant (0-2 years old) [嬰孩（0-2歲)]

意外事故責任豁免同意

Liability Release Agreement – Release of All Claims

本人乃十八歲以上之成年人，在此代表本人（及含十八歲以下未成年的孩子）同意於參加 2025 年林奇堡中國基督徒退修會營會期間：不做任何有害於中大西洋中國基督徒退修會的行為。對於本人及家屬及未成年十八歲的孩子們，因參加休閒及其他活動，無論自然引起或人為疏忽所導致的個人身體傷害，疾病，財物損失，甚至死亡，不對大會，負責人，主辦單位及其他同工們追究任何法律刑事責任，也不索賠或要求任何民事的金錢與精神損害賠償。以上聲明乃具法律功效，請仔細閱讀同意後再簽名。

In consideration for being accepted by The Mid‐Atlantic Chinese Christian Conference Inc. for participation in the Chinese Christian Conference ─ Lynchburg 2025 the undersigned being 18 years of age or older, do for myself (and for and on behalf of my child‐participant(s) if said participant(s) is/are not 18 years of age or older) hereby release, forever discharge and agree to hold harmless The Mid‐Atlantic Chinese Christian Conference Inc. and the directors or agents thereof from any and all liabilities, claims or demands for personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the child‐participant(s) while participating in the above described activity.

本人乃十八歲以上之成年人，在此代表本人（及含十八歲以下未成年的孩子）于閱讀以上意外事故責任豁免同意書說明以後，完全同意意外事故責任豁免同意書所敘述之內容。本人並申明，作為下列未成年者之合法監護人，謹全權代表該與會之未成年者。同意意外事故責任豁免同意書所敘述之內容，並承擔該未成年者之全部責任。

Furthermore, we (I) [and on behalf of our (my) child‐participant(s) if under the age of 18 years] hereby assume all risk of personal injury, sickness, death, damage, and expense as a result of participation in recreation and other activities involved therein. The undersigned further hereby agree to hold harmless and indemnify The Mid-Atlantic Chinese Christian Conference Inc., its directors, employees, and agents, for any liability sustained by said organization as a result of the negligent, willful or intentional acts of said participant and/or his or her child‐participant(s), including expenses incurred attendant thereto.

通過在下方的簽名，我承認我已閲讀並理解上述内容，並且接受所包含的條件。我用我的簽名在下面聲明，我是所述孩子的法定監護人。
By signing below, I acknowledge that I have read and understood the above and that I accept the conditions contained herein. I also represent with my signature below that by signing on behalf of the child/children indicated below, I am the legal guardian of the said child/children.
NOTE: In case there are discrepancies in the Chinese translation, the English version takes precedence.

All attendees under the age of 18 must have a parent/guardian’s signature. Every youth will be assigned to the same lodge as his/her guardian.
Signature 簽名 (Parent/Guardian Name, if under 18)(18 歲以下的必須家長或監護人簽名) *
Typing your name above constitutes your electronic signature and acceptance of this agreement.
Date 日期*

MonthDayYear
Should be Empty:

- 2025 年林奇堡中國基督徒退修會報名表 - Lynchburg Conference 2025 Online Registration