NDYC '26

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WHAT: North Dakota Youth Convention

WHEN: October 22-24

Depart HOC Thursday @ 1:30 PM; Return to HOC Saturday @ 3:00 PM

If a school absence form is needed, please contact Pastor Toby.

WHO: Students in grades 6-12

WHERE: Northview Church, Fargo ND

HOW ARE WE GETTING THERE: Church provided vans

COST: $75/convention ticket $40/hotel room Total: $110

Make checks payable to HOC

Registration Deadline: Wednesday, October 14

OTHER: Money for 4 meals; spending money for the mall and other concessions (optional)
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Student Info* This field is required.
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Parent/Guardian* This field is required.
First Name
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Phone Number* This field is required.Parent/Guardian
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EmailParent/Guardian
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Secondary Emergency Contact* This field is required.
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Phone Number* This field is required.Secondary Emergency Contact
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Health HistoryCheck all that apply
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If any were checked previously please give a brief description/ any restricted activities/ any other health concerns that we should be aware of
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Health History* This field is required.
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Is the applicant's immunization records up to date (Do not send records)
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Health Insurance Information* This field is required.
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Activity Disclosure* This field is required.I understand that by signing this form I am giving permission for the listed student to participate in all activities. Every activity is carefully planned and adequately supervised by mature adults. However, even with the best of planning and precaution, unseen events can occur. By signing this form, the parent of guardian agrees to assume and accept all risks and hazards inherent in activities. They also agree to not hold Harvest Outreach Assemblies of God, its' employees or volunteer assistants, liable for damage, losses, and injuries to the person or property undersigned.
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Pictures and Videos Disclosure* This field is required.We authorize Harvest Outreach Church to use our child or youths likeness in photographs or video in any and all of its publications and other media. We will make no monetary or other claim against the church for the use of such photos or videos.
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Disciplinary Action Disclosure* This field is required.I understand that if my child or youth does not conduct his/herself in a Christ-like manner while attending events of Harvest Outreach Church, my child will receive disciplinary action. If that action includes being dismissed from the event, I will be responsible for transporting my child or youth home.
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Parent/Guardian Signature* This field is required.
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I, Students Name * agree to conduct myself in a Christ-like manner while attending the events of Harvest Outreach Church. I will attend all required meetings and cheerfully submit to those in authority over me. I will also obey any rule which may be implemented for a specific event. I realize that failure to adhere to these guidelines will mean disciplinary action and possible dismissal from the event and return home at my parent's expense.
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Student Signature* This field is required.
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