• 2026 C2NextGen New York Co-Hort

    2026 C2NextGen New York Co-Hort

  • Personal Information

    ~ Participant Information ~
  •  . .
  • Format: (000) 000-0000.

  • Emergency Contact Information

  • Format: (000) 000-0000.

  • Medical Information

  • I   *   *   give permission to the licensed physician selected by the program to hospitalize, secure treatment, anesthesia, or surgery for the person named on this form.

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          Full Price
          $634.00
            
          Installment Plan: 1 out of 4

          Note- this is the first deposit. Deposit 2: $178 Deposit 3: $178

          Deposit 4: $178

          $100.00
            
          Scholarship/Sponsorship Applied
          $634.00
            
          Total
          $0.00

          Payment Methods

          creditcard

        • Liability Release Form

          Release of all claims.

        • In consideration of being accepted by the New York Church of God for participation in the 2026 C2NextGen Co-Hort:

          We (I), being 18 years of age or older, for ourselves (myself), do agree that the information I have included in the application is true to the best of knowledge. 

          I hereby release, forever discharge, and agree to hold harmless the New York Church of God, its pastors, pastor’s council, trustees, and any employee, agent, driver, or any other person connected with said church, from any and all liability, 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/or the participant that occur while participating in the above-described trip or activity.

          Furthermore, (I) hereby assume all risk of personal injury, sickness, death, damage, and expense as a result of participation in recreation and work activities involved therein.

          The undersigned grants permission to the New York Church of God to use any photographs, videos, or audio recordings that include the participant taken during the program for promotional, fundraising, or educational purposes, without compensation.

          The undersigned acknowledges the risks associated with communicable diseases such as COVID-19. We agree to comply with all health and safety guidelines recommended by health authorities and the camp to protect the participants and staff.

          The undersigned acknowledges that there are no refunds for cancellations. However, any issues related to family health or personal illness will be handled on a case-by-case basis by the New York Church of God.

          The undersigned further agrees to hold harmless and indemnify the New York Church of God, its directors, employees, and agents, from any liability sustained by the church as the result of the negligent, willful, or intentional acts of the participant, including expenses incurred attendant thereto.

          The New York Church of God is not liable for lost, stolen, or damaged personal items brought by participants.

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