The Topic of this convention is Why am I unique? 

"I have given them Your word; and the world has hated them because they are not of the world, just as I am not of the world." -John 17:14

What makes you feel unique?

 
What's your first and last name? *

 
What is your address? 
(Street, City, State, Zip-Code)

 
What is your birthday?

 
What is your T-shirt size?


 
What grade are you currently in?


 
What church do you attend?


 
What is the name(s) of your parent(s)?

 
What is your parent(s) house phone number?

 
What is your parent(s) cell phone number?

 
What is the name and number of someone we can contact in case of emergency?

 
Do you have any food allergies we need to be aware of?

 
Do you have any medical conditions that need our attention?

 
For parent/guardian:
By typing full name and completing this form with child I, parent/guardian of Child,

(1) Give permission to my child, to participate in this convention through the church.
(2) I agree that my child will abide by all the rules and regulations of the activity and the instructions of the activity leaders; otherwise, he/she may be returned home.
(3) I permit the Church, the activity leaders, or whom they may designate, to act on my behalf in case of medical emergencies pertaining to my child, during the activity.
(4) I authorize the medical doctor or hospital to act as they see fit to treat my child in case of emergencies; I will be responsible for the cost of the treatment.
(5) I release the Church, priest, directors and members as well as the activity leaders from all liabilities or responsibilities that may arise from events during the activity.

 
Do you have any questions, and or concerns?

 
Please give your $100 convention fee to your church representative. 
Thank you and see you soon!
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