Registration for Young Peoples Winter Conference at Sandy Cove

REGISTRATION FORM

Registration policy – Each person coming to Winter Youth Conference must complete a registration form and mail it with a check for the conference fee to the Registrar’s address listed below. Registrations cannot be accepted after the registration deadline because it causes logistical difficulties with room assignments and conference material planning. The cost of the conference is $185.00 USD. Your funds are not refundable except for extreme circumstances. The registration deadline is December 17, 2012. Mail registration: Winter Youth Conference c/o Mr. Anthony Taitt; P.O. Box 31 Monmouth Jct., NJ08852Info: Tel. 609-213-0233; . Make checks payable: Young Peoples Winter Youth Conference. Please remember to register early!

Conference information – Winter Youth Conference begins on December 26 with Supper (5 PM) and concludes on December 29 with Breakfast (8 AM). Please remember to bring your Bibles and Spiritual Songs hymnbooks, and head coverings. Remember to pack appropriate clothing for the Bible study and Gospel/ Ministry meetings and clothing to enjoy the outdoor and indoor activities. Our conduct is to be in keeping with the testimony we bear for the Lord and to be compliant with the guidelines of SpruceLake Retreat.

Room Assignments – SpruceLake Retreat provides motel and inn style rooms for sleeping accommodations. Room assignments will place 3-4 persons in a room. Accommodations are on first come first serve basis. Register early!

Information

Name ______Date of Birth (m) ______/ (d) ______/ (y) ______

Address ______City______State ______Zip ______

Telephone ______Age ______Male ______Female ______

Choice of one roommate (we will do our best to honor your request) ______

Email address ______

Parent, Guardian or Responsible Party

Name ______Relationship (Father/Mother/Guardian) ______

Address ______City______State ______Zip ______

Telephone ______Insurance Provider ______

Effective Date ______Policy # ______

Signed by individual attending conference - I, the undersigned, acknowledge my obligation to abide by all the rules and standards of behavior that have been established by Spruce Lake Retreat Facility and the brethren who are responsible for the oversight of the Young Peoples Winter Conference. I understand that if my behavior does not confirm to these standards, I will be subject to whatever consequences are deemed appropriate by WYC staff.

Signature ______Date ______

Signed by parent/ guardian of individual attendingconference - I, the parent of guardian of the above name registrant (18 and under) grant my voluntary consent to the terms listed above. Furthermore, I authorize health professionals retained by Spruce Lake Retreat and/or the Young Peoples Winter Conference to use their best judgment in administering treatment for minor illnesses and/or first aid, as they deem appropriate.

Signature of parent/ guardian ______Date ______

*There is a $20.00 discount off the cost of the conference to anyone who brings someone who has never attended the conference before.