2021 Illinois District Fine Arts Festival

2021 Illinois District Fine Arts Festival

PARTICIPANT Registration Form
PLEASE READ CAREFULLY BEFORE PROCEEDING:

This form must be filled out for each Participant in Fine Arts Festival. The Fine Arts Coordinator of your church will fill out a Church Registration Form that includes the Participant info that you provide here as well.

IMPORTANT: PLEASE CONNECT WITH THE FINE ARTS COORDINATOR OF YOUR CHURCH BEFORE COMPLETING YOUR REGISTRATION. You must obtain the Coordinator's email address before completing your Participant Form. Once you have obtained your Coordinator's email address, you may continue. Failure to provide a correct email address for your Coordinator could cause your registration to be considered incomplete.

Participant Registrations received by March 19 to qualify for Early Registration rates:

$49 PER INDIVIDUAL (INCLUDES UP TO 3 CATEGORIES)
$10 PER EACH ADDITIONAL CATEGORY (4+ CATEGORIES)
$10 PER INDIVIDUAL IN A YOUTH CHOIR ONLY
OPTIONAL T-SHIRT: $10 FOR S-XL; $12 FOR 2XL-3XL
$10 OFF FOR IL CREDENTIALED PASTOR’S KIDS

Participant Registrations received March 20-26 qualify for Regular Registration rates:

$59 PER INDIVIDUAL (INCLUDES UP TO 3 CATEGORIES)
$10 PER EACH ADDITIONAL CATEGORY (4+ CATEGORIES)
$20 PER INDIVIDUAL IN A YOUTH CHOIR ONLY
OPTIONAL T-SHIRT: $10 FOR S-XL; $12 FOR 2XL-3XL
$10 OFF FOR IL CREDENTIALED PASTOR’S KIDS

No Participant Registrations accepted after March 26th.

(Church Registrations are handled separately by the Fine Arts Coordinator and have separate deadlines.)
1. Registrant Information
Registrant Type: *

Fine Arts Participant Kappa Tau Participant
Name *

First Name Last Name
Grade (2020/2021) *
Age (on 09/01/2020) *
Birth Date *

Month Day Year
Date
Gender *

Male Female
Mailing Address *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
Email (or Parent Email) *

Confirmation Email Confirm email
Will you be ordering a Fine Arts 2021 t-shirt? ($10 S-XL; $12 2XL-4XL) *

Yes No
T-shirt S-XL (Optional)
$10 for Size S-XL
T-shirt 2XL-4XL (Optional)
$12 for Sizes 2XL-4XL
I do not give permission for the personal information above to be given to any other AG institution, school, or ministry other than my district office, NYM, and National Fine Arts

2. Church Information
Official Church Name (Listed by Illinois City, in Alpha Order) *
Please check carefully. If not listed, choose "Other" from bottom of list.
If Other (please double check)
Official Church Name:
City
Church City
State
Church State
Official District Name *
Senior Pastor

First Name Last Name
Youth/Fine Arts Coordinator *

First Name Last Name
Youth/Fine Arts Coordinator Email *

Confirmation Email Leader email REQUIRED for confirmation purposes
Youth/FA Coordinator Phone Number

Area Code Phone Number
Youth/FA Coordinator Mailing Address

Street Address

Street Address Line 2

City State

Zip Code

3. Medical & Photograph/Video Release
Registrants Full Name *

First Name Middle Name Last Name
I, the parent or legal guardian of Child, understand that I will be notified in the case of a medical emergency involving the Child. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event the Child is injured or becomes ill. We authorize the Temporary Guardian or any leader on this trip to make emergency medical care decisions on behalf of the Child, if required by law or a health care provider.

I, the parent or legal guardian of Child, understand that The General Council of the Assemblies of God and its affiliated ministries, and/or any Assemblies of God church and/or District Council, and/or any Assemblies of God school, college or university (collectively “GC”) and/or any of their officers, directors, employees, volunteers, and agents, shall not be responsible for medical expenses incurred on the basis of this authorization, and I hereby agree to hold harmless, defend and indemnify “GC”, its parents, subsidiaries and affiliates, officers, directors, employees, volunteers and agents from all obligations, damages, losses, attorney’s fees, defense costs, demands, investigations, actions, liabilities, claims, cross-actions, third-party actions, causes of action, of any kind or nature whatsoever, pertaining to the provision of medical services for the Child. It is my express intention to defend, indemnify and hold harmless “GC” from all claims arising out of, or resulting from, or in any manner relating to the treatment, medical or otherwise, of the Child. I agree to notify “GC” in the event of any health changes which would restrict the Child’s participation in this ministry event. I also understand that any “GC” representative reserves the right to restrict the Child from any activity for any reason.
Medications to which the registrant is allergic
Is there anything in the registrant’s medical history staff should be aware of incase of a medical emergency?
Emergency Contact *

First Name Last Name
Emergency Phone *

Area Code Phone Number
Photograph & Video Release

I hereby grant GC permission to the rights of the Child’s image, likeness, and sound of their voice as recorded digitally or on audio or video tape without payment or any other consideration. I understand that the Child’s image may be edited, copied, exhibited, published, or distributed and waive the right to inspect or approve the finished product wherein the Child’s likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the Child’s image or recording.

I agree that GC may use such images of the Child with or without the Child’s name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content.

There is no time limit on the validity of this release nor is there any geographic limitation on where these materials may be distributed. I acknowledge that I have completely read and fully understand the above release and agree to be bound thereby. I hereby release, defend, hold harmless and indemnify GC from any and all claims for utilizing this material.

4. Signatures
1. Registrant Signature (required regardless of age) Your signature indicates that you have completely read and understand the 2021 Fine Arts Official Rulebook, guidelines, and medical release and will abide by them. *

Clear
Date

Month Day Year
Date
2. Parent Signature (required for ALL registrants under 18) Your signature indicates that you understand and support your child’s involvement in Fine Arts and will abide by all rules, guidelines, and medical release. *

Clear
Date

Month Day Year
Date
3. Pastoral Signature also required.

There is also a Pastoral Signature form that must be submitted by your pastor by March 29, 2021. There will be a link to the Pastoral Signature Form in the Confirmation Email that you will receive after submitting your Participant Registration. Be sure to forward this on to your pastor for his/her signature, it is a required step of the registration process.

Kappa Tau Category Selection

Kappa Tau Participants ONLY (High School Graduates)

Art Division - Kappa Tau
Art Division (Kappa Tau) 1 - Choose Category:
Art Division (Kappa Tau) 2 - Choose Category:
Art Division (Kappa Tau) 3 - Choose Category:

Communication Division - Kappa Tau
Communication Division (Kappa Tau) 1 - Choose Category:
Communication Division (Kappa Tau) 2 - Choose Category:
Communication Division (Kappa Tau) 3 - Choose Category:

Dance Division - Kappa Tau
Dance Division (Kappa Tau) 1 - Choose Category:
Dance Division (Kappa Tau) 2 - Choose Category:

Drama Division - Kappa Tau
Drama Division (Kappa Tau) 1 - Choose Category:
Drama Division (Kappa Tau) 2 - Choose Category:
Drama Division (Kappa Tau) 3 - Choose Category:

Instrumental Division - Kappa Tau
Instrumental Division (Kappa Tau) 1 - Choose Category:
Instrumental Division (Kappa Tau) 2 - Choose Category:

Vocal Division - Kappa Tau
Vocal Division (Kappa Tau) 1 - Choose Category:
Vocal Division (Kappa Tau) 2 - Choose Category:
Vocal Division (Kappa Tau) 3 - Choose Category:

Writing Division - Kappa Tau
Writing Division (Kappa Tau) 1 - Choose Category:
Writing Division (Kappa Tau) 2 - Choose Category:
Not applicable base on one or more of your selections, click next to continue.

Registration for Participants must be completed March 19, 2021 for early discount and March 29, 2021 for regular rate. (Payment to ISM is made per church for all participating students, please see the Fine Arts Coordinator of your church for payment of fees. ISM does not accept payment directly from Participants).

NO REGISTRATIONS WILL BE ACCEPTED AFTER March 29, 2021. No on-site participant registrations will be accepted. No exceptions.

No non-participants will be admitted this year due to capacity limits. The only exceptions will be your Church's Fine Arts Coordinator, any accompanists needed for your performance, and/or persons needed to transport the church group to the venue.

IMPORTANT:

You will receive both a confirmation page and a confirmation email after submission. If you do not receive these, then your submission was not successful. Please contact our office at ilsmonline@idcag.org or 217-854-4641 with any questions.
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2021 Illinois District Fine Arts Festival

1. Registrant Information

2. Church Information

3. Medical & Photograph/Video Release

4. Signatures

Fine Arts Category Selection

Kappa Tau Category Selection