• CELEBRATE@YOUTHQUAKE TEEN ENTRANT & ADULT REGISTRATION FORM - PART I

  • (Form Due by: October 1st; Mail Forms to: Ensley COTN ATTN Jake Hill 8300 N Palafox St. Pensacola, FL 32534
    Mail Checks to: Cheryl Hodo 9473 Crete Circle, Tuscaloosa AL 35406
    (Please PRINT all information)
    District: Central Gulf Coast

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Date of Birth*
     - -
    2 digit month, 2 digit day, 4 digit year
  • (Check one)*
  • Check Shirt Size:*

  • TEEN ENTRANT INFORMATION

  • GENDER*
  • AGE LEVEL
  • AGE LEVEL IN INDIV. SPORTS
  • RULE: Entrants can compete in no more than THREE categories. In Toumament Style Events, a Student may compete on ONE Tier One Level Tournament Style Event*, and ONE more Tier Two Level Tournament Style Event** counting toward their THREE Categories; OR, A Student may compete in TWO Tier Two Level Toumament Style Events** counting toward their total of THREE Categories; HOWEVER, a student may NOT compete in TWO Tier One Level Tournament Style Events*, regardless of the number of categories in which they are competing. Exhibition Event***
  • PLEASE NOTE KEY WHEN SIGNING UP FOR EVENTS: *Tier One **Tier Two Exhibition Event***
  • Bible Quizing
  • Art
  • Creative Ministry
  • Speech
  • Creative Writing
  • Academics
  • Vocal Music
  • Instrumental Music
  • Individual Sports
  • Team Sports

  • TNT REGISTRATION FORM - PART II

  • Dates: November 6th-8th
    Times: 4:30 PM
    Fees: On or before OCT 1st = $85
    Received After OCT 1st = $100
  • Place: Camp Baldwin
    8749 Baptist Camp Rd
    Elberta, AL 36530
    www.campbaldwin.org
  • All chaperons MUST have completed the Sexual Awareness Training on the Ministry Safe website and provide a certificate of completion dated no more than two years prior to Event to Diane Thompson (dthompson@retiree.ua.edu). If you have one on file with NYI, NMI or the district office, confirmation must be presented.

  • INSURANCE AND MEDICAL INFORMATION - (All participants must be covered by their own personal insurance.)

  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.
  • TEEN: I promise to live within the campground guidelines during Celebrate @ Youthquake. I also promise to cooperate with District sponsors and be under their authority. I am aware that failure to do so will result in disciplinary action.
  • PARENTS: I hereby give authority to Diane Thompson or Mike Mcgee, who is the NMI President and Celebrate Coordinator of the Central Gulf Coast District, to obtain necessary medical attention or to authorize treatment at any hospital in the event of a medical emergency. I also recognize the authority of all adult sponsors as those who will supervise this event and uphold proper conduct. The first step of discipline, should such become necessary, will be a warning and instruction. The second will be a telephone call to the parent or guardian concerning the participation of my son/daughter. I understand that the event of Celebrate@Youthquake will require my son/daughter to make choices and to keep a schedule, and that he/she may not be under direct adult supervision at all times. I agree to release and hold harmless any and all staff and lay assistants of the Central Gulf Coast District NYI from any and all claims, suits, costs, and actions of any kind whatsoever, arising from their exercise of the power granted by this authorization, unless due to verifiable negligence. My son/daughter has my permission to attend Celebrate@Youthquake. NOTE: Valuables should be left at home!
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