Youth Awakened 2022 Registration

Registration:

Youth's Name

Youth's Gender

Male
Female

Youth's Date of Birth

Grade Entering

T-Shirt Size (Unisex Adult)

Is your youth attending with their youth group?

Special Notes (Ex. Must be with youth group/siblings. Please note: We will be mixing up youth groups.)

Does your youth have any condition which would prevent them from participating in activities?

Other medical conditions

Is this youth presently being treated for an injury or sickness or taking any form of medication for any reason?

If Yes, Please Explain

PARENT/GUARDIAN INFORMATION

Parent/Guardian 1 Name

Parent/Guardian 1 Phone Number

Parent/Guardian 1 Email

Parent/Guardian 2 Name

Parent/Guardian 2 Phone Number

Country

Address

City, State and ZIP Code

MEDICAL INFORMATION

Medical Insurance Company

Policy Number

Individual Number

Family's Doctor Name

Doctor's Phone Number

RELEASE FORMS

Put model release form here

Permission to Photograph During Youth Awakened 2022

I agree to consent to a model release for my child
I do not agree to consent to a model release for my child

Terms & Conditions:

Youth going into 6th grade and completed 12th grade are eligible to register for Youth Awakened. Youth must be going into 6th at the time of the conference start date. No onsite registration is available. All Youth Awakened attendees must pre-register. No translation is available. All youth must speak fluent English. Unfortunately at this time, we are unable to accommodate youth with special needs.

If a parent/guardian picks their youth up late more than twice, a warning will be issued. If a third time occurs then said youth will no longer be able to participate in Youth Awakened during the duration of the conference.

Terms & Conditions

I have and agree to these terms

MEDICAL TREATMENT AUTHORIZATION

We understand that we will be notified in the case of a medical emergency involving our child. However, in the event that we, or either of us, cannot be reached, we authorize the calling of a doctor and the providing of necessary medical services in the event our child is injured or becomes ill. We authorize any one or more of the following persons to make emergency medical care decisions on behalf of our child if required by law or a health care provider: Any Global Awakening Staff member or Youth Awakened Volunteer Team Member.

We understand that the Global Awakening Staff, or any of their agents, employees, or volunteers, will not be responsible for medical expenses incurred on the basis of this authorization.

We agree to notify the Global Awakening Staff in the event of any health changes which would restrict our child's participation in any activities. We also understand that Global Awakening representatives reserve the right to restrict our child from any activity that they do not feel is within the physical capabilities of our child.

CONSENT AND CERTIFICATION

We, the undersigned, being the parents or legal guardians of the child named above (the "child"), do hereby consent to the participation of our child in the activities of the Youth Awakened program, including dancing and any other activities customarily associated with a children's program. Further, we certify that our child is physically able to participate in such events.

Terms & Conditions

I have read and agree to these terms and conditions

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