Youth Forum Registration 2019

Youth Forum 2019

--------------------------------May 23-26, Sackville NB-------------------------------Youth Forum is a place of community, a place of faith, a place of visioning, a place for the work of the church, and a place of social relationships. At Youth Forum, an inclusive, diverse and safe community of over a hundred youth gathers as one in the name of Christ to provide a place for youth to explore their faith and to learn more about themselves. Over the course of the four days, where reflection and action come together, we’ll explore what we believe and how we are called to live, while sharing in music, worship and fun in a spirit-filled community.
Participant First Name *
Participant Last Name *
Preferred Name

Participant Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Participant's Mobile Number *

- Area Code Phone Number
Date of Birth *

- Month - Day Year
Gender (ie. male, female, nonbinary, trans*) *
Grade/University/ College year *
Age at event (May) *
Participant Email *
example@example.com
Parent/Guardian Email *
example@example.com
Have you ever attended Youth Forum or Intermediates before? *

Yes No
If you have attended before, in which years did you go to camp?

2018 2017 2016 2015 2014 Pre-2013

Primary Parent's/Guardian Full Name *

First Name Last Name
Primary Phone Number (while at the event) *

- Area Code Phone Number
Secondary Parent/Guardian Full Name

First Name Last Name
Secondary Parent/Guardian Phone Number (while at the event)

- Area Code Phone Number
Emergency Contact: (other than parent/guardian) *

First Name Last Name
Emergency Contact Phone Number *

- Area Code Phone Number
Emergency Contact Relationship *

GENERAL HEALTH INFORMATION:
Provincial Health Card issued in which province *
Provincial Health Card # *
Any medical concerns including: asthma, diabetes, seizures, heart conditions, ADD/ADHD, earaches, allergies or any other medical concerns that you think we should be aware.
Provide details of any additional concerns we should be aware of (family loss or change, concerns at school)
Any dietary concerns for the participant.
Any behavourvial issues that we should know about.

Tell us about you.
1. Where do you see God at work in the world, or in your life? Where do you feel close to God? *
2. What is really important to you and why? (Friends, family, music, school, church, sports, other?) *
3. Is there a world issue or local issue you feel strongly about? Why? (Gender equality, hunger, homelessness, animal rights ... etc) *
4. Tell us something about yourself! Do you have a special talent or skill? Do you play a musical instrument? Are you a great friend? A funny person? What types of activities do you like to take part in after school or in the summer? *
5. If you're returning for another year, what made you apply to come back this year?

Payment
Tier Payment

We realize that families have different abilities to pay; Youth Forum and Intermediates now offer a voluntary three tier payment program. You many choose the tier that is most suitable for your family. The Tier System allows us to continue to offer an incredible program, while letting everyone know the true cost and how to help support the programs for the future. You may choose the tier that is most suitable for your family.
- Tier I more closely accounts for the true costs of running the program ($295)
- Tier II is our partially subsidized fee for those who can pay a little more but still cannot afford the actual cost. ($265)
- Tier III is our subsidized rate and does not reflect the true cost of operating the programs. ($235)
This program is voluntary and in no way influences the experience your child receives, yet it offers the opportunity for families to take an active role in supporting the true cost of your youth's experience. Our goal is to provide each youth with a positive and lasting experience. The information about how much you pay is only seen by our Registrar and Regional Council staff.
How are you paying? *
Paying by e-transfer:

If you live in Nova Scotia or Bermuda (Region 15), send e-transfer to Info4RC15@united-church.ca password: YF2019

If you live in New Brunswick or PEI (Region 14), send e-transfer to Info4RC14@united-church.ca password: YF2019
IMPORTANT NOTE: If you are paying by E-Transfer, your church is paying, you're paying by cheque or another method that is NOT credit card, type in

GODISLOVE into the coupon field below.

If you are paying by credit card right now, do not type anything into the coupon field.
Enter the message as it's shown *

My Products

Tier 1 $ 295.00 CAD

Tier 2 $ 265.00 CAD

Tier 3 $ 235.00 CAD

Enter coupon

Total $ 0.00 CAD

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Youth Forum 2019

Tell us about you.

Payment

Tier Payment