Fall Youth Convention: Registration

Fall Youth Convention: Registration

Use this form to register students for Fall Youth Convention (FYC) with New Life Youth.
Register Your Student(s)

Select the "Add New" button to register additional students in your care.
Student Information
Will any of the children in your care bring their own medications, prescribed or otherwise?
PLEASE NOTE:
All medications, whether prescribed or over the counter, should be included in the "medications/medical note" field above, and all medications must be submitted to an adult room leader at drop-off in the original container and label for the safety of your child(ren) and all other children under our supervision.
- Medications will be administered by your child's room leader as instructed or made necessary (as applicable)
  - For example, if a student has a twice daily medication, your child's adult room leader will ensure they receive their medication at the specified times and specified dosage.
    OR
  - For example, if your child has a headache and wants to take Tylenol, they will ask their adult room leader, and the adult room leader will give them the appropriate dose (as instructed in the "medications/medical note" field).
- Any medications found will be confiscated by a chaperone immediately and reported to the legal guardian of the aformentioned student for verification that they are permitted to take the medication which was found.
Again, this is for the safety of your child(ren) and all other children under our supervision.
Parental Contact Information

Follow-up details will be sent to the email of the primary parental guardian.
Primary Parental Guardian

First NameLast Name
What is your relationship to the student(s) in your care?

Other
Primary Email
Additional information will be sent to this address.
Primary Phone
Please enter a valid phone number.Format: (000) 000-0000.
Would you like to add a secondary emergency contact?
Secondary Parental Guardian

First NameLast Name
What is the secondary's relationship to the student(s) in your care?

Other
Secondary Email
Additional information will be sent to this address.
Secondary Phone
Please enter a valid phone number.Format: (000) 000-0000.
Permissions and Acknowledgements

Please review the following permissions and acknowledgments before completing registration.
Participation & Transportation

I give permission for the student(s) listed on this registration to participate in New Life Church’s Fall Youth Convention trip and all related activities. I also give permission for my student(s) to be transported to, from, and during the event in transportation arranged or approved by New Life Church.

Medical Care & Medication Authorization

I authorize New Life Church staff and designated adult leaders to provide reasonable first aid and, when necessary, seek emergency medical treatment for my student(s). If I cannot be reached in an emergency, I authorize leaders to contact emergency medical services and/or arrange transportation to an appropriate medical facility.

I authorize designated adult leaders to supervise and administer medications provided for my student(s) according to the instructions submitted with this registration and New Life Church’s medication procedures.

I understand that I am responsible for any medical expenses incurred on behalf of my student(s).

Assumption of Risk & Release

I understand that participation in Fall Youth Convention, including travel, lodging, recreational activities, group activities, and other aspects of the trip, involves certain risks, including the possibility of illness, accident, injury, loss, or damage.

I knowingly permit my student(s) to participate and assume the ordinary risks associated with their participation.

To the extent permitted by law, I release and agree not to hold New Life Church, its pastors, staff, volunteers, leaders, drivers, or representatives responsible for injury, loss, or damage resulting from the ordinary risks associated with participation in this event, except where liability cannot legally be waived.

Student Conduct

I understand that my student(s) are expected to follow the instructions of New Life Youth leaders, respect others and property, remain with their assigned group, and follow the expectations established for the trip.

I understand that serious or repeated behavioral issues may result in a parent or guardian being contacted and, if necessary, arrangements being made for the student to return home.

Parent/Guardian Acknowledgment

By signing below, I confirm that I am the parent or legal guardian of the student(s) listed on this registration, or that I otherwise have legal authority to provide consent on their behalf.

I certify that the information provided in this registration is accurate to the best of my knowledge. I acknowledge that I have read, understand, and agree to the permissions, authorizations, assumption of risk, release, and expectations stated above. I intend my electronic signature below to serve as my signature and acknowledgment of these terms.

Parent/Guardian Full Legal Name
{primaryParental}

Relationship to Student
{whatIs}
Signature

By signing above, I confirm that I have read, understand, and agree to the permissions, authorizations, release, and terms stated above.
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Hour MinutesAM/PM Option
Payment

An initial deposit of $25 per student is required to register.
A fundraising opportunity will be available before the remaining balance is due. Students must participate in some capacity in order to receive a portion of the funds raised.

After fundraising is complete, an invoice for the remaining balance of your student(s)’ registration will be emailed to you.

Scholarship assistance will also be available for families who may need additional financial support.

Continue below for payment instructions.
Choose a payment method:

Register

FYC: Initial Deposit

This amount will be subtracted from your remaining amount after fundraising efforts occur.

$25.00 Quantity

Optional: Pre-Order T-Shirt

Provided by Fall Youth Convention (no preview available). Limit 1 per student.

$25.00

Size	Quantity	Price
S		$25.00
M		$25.00
L		$25.00
XL		$25.00
XXL		$30.00
XXXL		$30.00

Item subtotal:

Enter coupon

Total

Payment Methods

Credit Card

Apple Pay

Google Pay

Paying by cash or check?

Please place your payment ($25 down deposit) in a giving envelope and include:

1. The name(s) of the student(s) you are registering
2. The date
3. Write in “FYC Registration”

Then drop the envelope into the offering box at New Life Church.

Checks can be made payable to "New Life Church" with the memo "FYC Registration"
Should be Empty:

Fall Youth Convention: Registration

Register Your Student(s)

Parental Contact Information

Permissions and Acknowledgements

Payment

Register*

Payment Methods

Register