Adult Registration Form - Only
Youth in Action Day
February 4, 2017
Official Use Only
January 7, 2017 after 12:00 pm thru February 4, 2016 (On-Site Fee)
Registrations received after 12:00 pm on January 7, 2017 will be considered as "On-Site Registration"
(General Registration Fee) (On-Site Fee)
$13.00 Ages 26yrs, and older $20.00 Ages 26yrs, and older
(PLEASE PRINT CLEARLY)
Name: Last ______First ______M.I. _____
Church: ______Phone#: ______District: ______
Pastor: ______
I am a: Coordinator Helper: (event) ______Participant Church Rep District Rep Guest
Events:
ADULT SEMINARS: Select and Write 1st and 2nd Sessions Choice
_____Adult Workshop _____Single and Single Again (Women ONLY)
____ Life of COGIC/who is Bishop Charles H. Mason? ____ COGIC Doctrine
_____Prayer Room "Come as you are" ____ Pastors Wives Workshop (All Day – Pastor Wives Only)
_____Introduction to Church Program Design & Advertisement (1st Session ONLY)
_____Computers (2nd Session ONLY) _____Choir
_____Effective Teaching Methods _____Elders Wives Workshop (All Day)
_____Administrative Asst. & Superintendents (1st Session Only) _____Pastors & Elders (2nd Session Only)
______Amount Paid (circle one) Cash or Check, if check write “Check number” ______
Make all checks payable to: Northern GA Second COGIC Fine Arts Department
Send to: Elder Boris A. Williams
577 Jackson Street
Grovetown, GA 30813
Youth Registration Form - Only
Youth in Action Day
February 4, 2017
Official Use Only
January 7, 2017 after 12:00 pm thru February 4, 2017 (On-Site Fee) Registrations received after 12:00 pm on January 2, 2016 will be considered as "On-Site Registration"
(General Registration Fee) (On-Site Fee)
$4.00 Ages 3 - 11yrs. $4.00 Ages 3 - 11yrs.
$7.00 Ages 12 - 18yrs. $10.00 Ages 12 - 18yrs.
$10.00 Ages 19 - 25yrs. $15.00 Ages 19 - 25yrs.
$13.00 Ages 26yrs, and older $20.00 Ages 26yrs, and older
(PLEASE PRINT CLEARLY)
Name: Last ______First ______M.I. _____
Age: ______(if under 26yrs old) Grade: ______
Church: ______Pastor: ______
District: ______Phone #:______
I am a: Coordinator Helper: (event) ______Participant Church Rep. District Rep. Guest
*Select and write the #1 & #2 once on the line by the event you would like to attend, which you can
toggle between the non-competitive or competitive events. Then write the #3 & #4 next to an unlimited
event to be used only if your 1st & 2nd events are filled at the time when your church registration forms are
turned in. You do not have to write the #3 or #4 if you have already selected #1 or #2 as your unlimited event.*
NON - COMPETITIVE EVENTS:
(“PLEASE”, look closely for “1st or 2nd Sessions Only”)
Events:
___ Children’s Church, Ages 1 - 5yrs ___ Tambourine Band, Ages 1 – 10yrs (1st Session ONLY - unlimited) ____Arts & Crafts ___Tambourine Band, Ages 11yrs & Up (2nd Session ONLY - unlimited)
___ Drill Team, Ages 8yrs & up (Unlimited) ___Jump Rope, Ages 6yrs. & up (Unlimited)
____Intro to Church Program Design & Advertisement, 13-25yrs (2nd Session ONLY)
____Robotics 101, 6th-12th grades (1st Session ONLY-Max 10) ____ Special Needs Co Ed Class 5 & 17 yrs old
____ Computers, Ages 9-12 yrs. (1st Session Only) ____Computers Ages, 13 & Up (2nd Session Only)
Seminars:
____Choir, Ages 10 yrs. & up (Unlimited) ____ Liturgical Praise Dancers, Ages 9 yrs. & up
____ Young Women, Ages 18-25yrs ____ Gentlemen, Ages 18-25yrs
____ Men of Valor, (1st Session 09-12yrs) ____ COGIC Girls Rock, (1st Session 09-12yrs)
____ Men of Valor, (2nd Session 13-18yrs) ____ COGIC Girls Rock, (2nd Session 13-18yrs)
COMPETITIVE EVENTS: (Must be a Northern GA Second COGIC member to compete) (“PLEASE”, look closely for “1st or 2nd Sessions Only”)
Events:
____ Bible Recitation, Grades 1st – 12th ____ Math, Grades 3rd – 12th (1st Session Only) ____ Space Challenge Essay, Grades 6th -12th ______Robotics (check here if competing) 2nd Session Only
____Oratorical, Ages 12 - 15yrs (Junior) (1st Session Only ____Oratorical, Ages 16 - 22yrs (Senior) (2nd Session Only
______Spelling, Grades 1st - 12th ______STEM Showcase (science project Session Only
(1 Junior & 1 senior 4 to 8 member District Teams)
___ Bible Bowl, Ages 5 - 15yrs (Junior) (1st Session)
___ Bible Bowl, Ages 16 - 22yrs (Senior) (2nd Session)
______Amount Paid (circle one) Cash or Check - with “Check number” ______
Make all checks payable to: Northern GA Second COGIC Fine Arts Department
Send to: Elder Boris A. Williams
577 Jackson Street
Grovetown, GA 30813
ON-SITE REGISTRATION FORM Youth Registration Only
Youth in Action Day
February 4, 2017
Official Use Only
January 7, 2017 after 12:00 pm thru February 4, 2017 (On-Site Fee) Registrations received after 12:00 pm on January 7, 2017 will be considered as "On-Site Registration"
$4.00 Ages 3 - 11yrs.
$10.00 Ages 12 - 18yrs.
$15.00 Ages 19 - 25yrs.
$20.00 Ages 26yrs. and older
(PLEASE PRINT CLEARLY)
Name: Last ______First ______M.I. ______
Age: ______(if under 26yrs old) Grade: ______
Church: ______Pastor: ______
District: ______
I am a: Coordinator Helper: (event) ______Participant Church Rep District Rep Guest
______Amount Paid (circle one) Cash or Check, Check number ______
Make all checks payable to: Northern GA Second COGIC Fine Arts Department
WRITE THE #1 & #2 TO INDICATE YOUR 1ST & 2ND SESSION
(BOTH CHOICES WILL BE CHECKED TO SEE IF SPACE IS AVAILABLE)
____Robotics 101, 6th-12th grades (1st Session ONLY-Max 10)
___ Bible Bowl, Ages 5 - 15yrs (Junior) (1st Session) ___ Bible Bowl, Ages 16 - 22yrs (Senior) (2nd Session)
(1 Junior & 1 senior 4 to 8 member District Teams)
NON - COMPETITIVE EVENTS:
___Children’s Church, Ages 1 - 5 yrs. _____ Special Needs Co Ed Class 5 & 17 yrs ___ Robotics 101 ___Tambourine Band, Ages 1 – 10yrs (1st Session ONLY - unlimited) ___ Arts & Crafts ___Tambourine Band, Ages 11yrs & Up (2nd Session ONLY - unlimited)
___ Drill Team, Ages 8yrs & up (Unlimited) ___ Jump Rope, Ages 6yrs. & up (Unlimited)
___ Arts & Crafts, Grades 6th-12th grades (1st Session Only)
____Computers, Ages 9-12, (1st Session Only) ____ Computers, 13yrs & Up, (2nd Session Only)
Seminars
____ Choir, Ages 10 yrs. & up (Unlimited) ____ Liturgical Praise Dancers, Ages 9 yrs. & up
____ Young Women, Ages 18-25yrs ____ Gentlemen, Ages 18-25yrs
____ Men of Valor, (1st Session 09-12yrs) ____ COGIC Girls Rock, (1st Session 09-12yrs)
____ Men of Valor, (2nd Session 13-18yrs) ____ COGIC Girls Rock, (2nd Session 13-18yrs)
____Introduction to Church Program Design & Advertisement (2nd Session ONLY) 15-25 yrs
Make all checks payable to: Northern GA Second COGIC Fine Arts Department
ON-SITE REGISTRATION FORM
Adult Registration - Only
Youth in Action Day
February 4, 2017
Official Use Only
January 7, 2017 after 12:00 pm thru February 4, 2017 (On-Site Fee) Registrations received after 12:00 pm on January 7, 2017 will be considered as "On-Site Registration"
(General Registration Fee) (On-Site Fee)
$13.00 Ages 26yrs., and older $20.00 Ages 26yrs., and older
(PLEASE PRINT CLEARLY)
Name: Last______First ______M.I. ______
Church: ______Pastor: ______
District: ______
I am a: Coordinator Helper: (event) ______Participant Church Rep District Rep Guest
Events:
ADULT SEMINAR: Select and Write 1st and 2nd Session Choice
“PLEASE” look closely for “1st or 2nd Sessions Only”)
_____Adult Workshop _____Single and Single Again (Women ONLY)
_____The Life of COGIC/Who is Bishop Charles H. Mason _____COGIC Doctrine
_____Prayer Room "Come as you are" ____ Pastor’s Wives Workshop (All Day – Pastor Wives Only)
_____Effective Teaching Methods ____ Elders Wives Workshop (All Day)
_____Introduction to Church Program Design & Advertisement (1st Session ONLY)
_____Computers (2nd Session ONLY) _____ Choir
_____Administrative Asst. & Superintendents (1st Session Only) _____Pastors & Elders (2nd Session Only)
______Amount Paid (circle one) Cash or Check, Check number ______
Make all checks payable to: Northern GA Second COGIC Fine Arts Department
Registration Summary Sheet 2017 Make all checks payable to:
Northern GA Second COGIC Fine Arts Department Send to: Elder Boris A. Williams 577 Jackson Street Grovetown, GA 30813 (706) 993-6381
Youth in Action
Church: ______
District: ______
Pastor: ______
Church Location: ______
Church Representative: ______
Phone Number: ( ) ______
Please Complete
A. *** Number of Persons Amount Paid
1. Ages 3 - 11 ______$______
2. Ages 12 – 18 ______$______
3. Ages 19-25 ______$______
4. Ages 26, and Older ______$______
Total ______$______
B. Church Love Offering: $______
C. Total amount enclosed: $______
Signature: ______Date: ______
Phone Number: ______
***Please ensure that there is enough money enclosed to match each registration form***