SR High CDYC - Clover Sites

SR High CDYC

Registration Packet June 26 - 30, 2013

3/1/2013 2:47 PM

SR High CDYC 2013…things YOU need to know! PLEASE, READ EVERYTHING!

DETAILS… (for SR High students, grades 9-12, remaining under age 20, through 6/30/13.) Speaker: Matt Piland Worship Leader: Brock O’Dell Theme: THRIVE Dates: June 26-30, 2013 Cost: $230 (by May14th) Location: Indiana Wesleyan University, 4201 S. Washington Street, Marion, Indiana 46953

QUESTIONS…Contact… Conference Director Sarah Lawrence 260-760-9254 [email protected] Registration/Housing Sarah Lawrence 260-760-9254 [email protected] Michael Lehman 260-627-3678 [email protected] Talent Quest Musette Anderson 847-548-5340 [email protected] Sports Olympics Mark Outcalt 317-831-5404 [email protected]

REGISTRATION PACKET… PRINT the ENTIRE CDYC registration packet, go to www.bethelcollege.edu/cdyc to sign up for Online

Registration. The “Registration Cost” area on the STUDENT form has been left blank. This allows you to write in

YOUR cost per student, include your transportation and any other fees you pass on to your students. Just remember to send $230 per student (A registration) or the $60 deposit (B registration) by Tuesday, May14th.

All registration forms must be signed by the student AND parent; PLEASE check this before mailing. Student registration forms can be scanned and emailed ([email protected]) this

year or sent with your registration check. MAKE COPIES OF EVERYTHING YOU MAIL IN!

DEADLINES… Students that register by the May 14th deadline are eligible to participate in sports and talent competition. We have the ability to ADD late registrants to EXISTING sports teams. Please call Sarah at 260.760.9254 if you have a late registration. Postmark your registrations and all other necessary forms by May 14, 2013. If you are hand delivering

your registrations to the Central Region Office, they must be in by 4:00 PM on May 15th or they will be considered late.

Please call the Central Region Office to verify available housing before sending any late registration forms.

QUESTIONS??? Please CALL, 260-760-9254 if you have any questions or extenuating circumstances.

SPONSOR/STUDENT RATIO… You are responsible to provide adequate sponsors for your group. You MUST provide one sponsor for every 10 students that you bring to CDYC. We strongly recommend a written screening form be used for each of the people coming with your students. This is for your own protection and the integrity of CDYC. PLEASE review the Sponsor Memo with your adult staff attending CDYC.

KEY DEPOSITS… You will be responsible for collecting a $10.00 key deposit from your students. Please have key deposits collected BEFORE you register at IWU. You will distribute dorm keys to your own group.

SH REGISTRATION PROCEDURE…

BEFORE CDYC… Please complete these steps…

When you receive the registration packet… _____ Print ENTIRE Registration packet and Rulebooks, PLEASE

PLEASE, copy Student Registration forms back to back _____ CDYC Registration is going High-Tech! Go online to

www.bethelcollege.edu/cdyc to sign up for online registration. _____ Watch Online Registration Tutorials at www.cdyc.info _____ Call Sarah (260-760-9254) or Michael (260-627-3678) if you have questions.

Before you send in forms… _____ Check all forms for student and parent signatures _____ Create sports teams and fill out Team Rosters _____ Make sure your team rosters have been filled out ONLINE _____ Fill out Talent Quest Group Entry Form _____ Place entry totals on Competition Totals page _____ Create your Housing List _____ Record t-shirt/sweet bag totals and youth group color on T-shirt/Sweet Bag Order Form _____ Complete Registrar’s Report Form _____ Write check to Central REGION

POSTMARK and MAIL BY MAY 14th

Please include the following… Signed student forms can either be scanned and emailed to Sue

([email protected]) or can be sent through the mail. Housing Talent Quest Group Entry T-shirt/Sweet bag totals Competition Totals - THIS IS IMPORTANT! Registrar’s Report Form Registration and T-shirt/Sweet Bag Money, ONE CHECK for the total

ALL DEPOSITS ARE NON-REFUNDABLE AND NON-TRANSFERABLE

Mail to: Central Region Office

3282 Mallard Cove Lane Fort Wayne, IN 46804

You will receive a confirmation notice and balance due statement.

Late Registrations??? Please contact Sarah at the Central Region Office for housing availability BEFORE mailing late registration forms.

REGISTRATION PROCEDURE Continued…

BEFORE arriving at CDYC… *One more reminder…be sure you have shared the Indiana Wesleyan Dress code with your students, (printed in CDYC Guideline and things you should know…) long BEFORE they get on the bus to come! *Collect their $10 room key deposit! Be prepared to make change!

AT CDYC…

Wednesday, June 26, 2013 Check In: 4:00 – 5:30 PM

(Indiana is on Eastern Daylight Savings Time)

Indiana Wesleyan University – Phillippe Performing Arts Center

Watch for signs to direct you as you arrive on campus! Remember each person will pay a $10.00 key deposit. This money will be refunded at the conclusion of the conference WHEN the room key is returned. The Youth Director OR Registrar should come to the Phillippe Performing Arts Center, BEFORE GOING TO THE DORMS, presenting ONE CHECK for whatever balance is due for your entire church group, PLUS your $10 cash key deposits for your ENTIRE group. He/she will receive the room assignments, KEYS, schedule information, wristbands, T-shirts and Sweet Bags for your group.

Your group will go to the assigned dorms and unload. DO NOT UNLOAD AT THE DORMS BEFORE YOU HAVE REGISTERED. PLEASE cooperate with this, it REALLY does reduce housing headaches!!!

REGISTRAR’S REPORT FORM

SR HIGH CDYC 2013

**Please include this form with each group of registrations sent in.

CHURCH/CITY______________________ E-Mail _________________________ Youth Director______________________ Daytime Phone __________________ Address __________________________ Cell Phone ______________________ __________________________ ON Time Registration packets include: this report form; individual registration forms; talent & sports sign-ups; T-shirt/Sweet Bag order form; housing lists and ONE check sent to: CENTRAL REGION OFFICE, CDYC 2013, 3282 Mallard Cove Lane, Fort Wayne, IN 46804

FULL TIME REGISTRATIONS Total “A” Registrations ________ X $230 = $________ postmarked by 5/14 Total “B” Deposits ________ X $ 60 = $________ postmarked by 5/14 Total “C” LATE Registrations ________ X $240 = $________ postmarked 5/14 – 6/1 Total “D” LATE Registrations ________ X $245 = $_______ postmarked 6/2 or later Total “E” Child Registrations ________ X $100 = $________ postmarked by 5/14

PART TIME REGISTRATIONS Total “F” Registrations ________ Adults X ________ Nights X $65 = ________ (12 & Older) Total “G” Registrations ________ Children X ________ Nights X $30 = ________ (5-11 years old)

Total People Registered: ________ = $________ Registration Total Total T-shirts Ordered: _______ @ $12 = $________ T-shirt Total Total “Sweet” Bags Ordered: ____ @ $18 = $________“Sweet” Bag Total TOTAL of Enclosed Check: $________ (payable to Central Region MYF)

Total Entries

TALENT QUEST:

PR Preaching ________ MS Motivational Speaking ________ ST Story Telling ________ DR Dramatic Recitation ________ DG Drama Group (2-5 people) ________ VS Vocal Solo ________ SAVS Self-Accompanied Vocal Solo ________ VG Vocal Group (2-5 people) ________ BS Brass Solo ________ WW Woodwind Solo ________ OS Orchestral Strings Solo ________ AG Acoustic Guitar Solo ________ ES Electric Guitar/Bass Solo ________ PS Pretuned Solo ________ PE Percussion Solo ________ PI Piano Solo ________ AC Accompanist (piano/guitar) ________ IG Instrumental Group (2-5) ________ WB Worship Band ________ CS Creative Movement Solo ________ CG Creative Movement Group (2-5) ________

DLG Drama Large Group (6 or more) ________ VLG Vocal Large Group (6 or more) ________ ILG Instrumental Large Group (6 or more) ________ CLG Creative Movement Group (6 or more)

________

DP Drawing/Painting Art ________ PH Photography Art ________ CW Creative Writing ________ PO Poetry ________ VI Video ________ VIG Video Group ________ UA Unique Art ________

Total Entries

SPORTS OLYMPICS: BSM Basketball MALE Teams ________ BSF Basketball FEMALE Teams ________ SSM Soccer MALE Teams ________ SMFA Soccer MALE Free Agents ________ SSF Soccer FEMALE Teams ________ SFFA Soccer FEMALE Free Agents ________ TTSM Table Tennis Singles MALE ________ TTSF Table Tennis Singles FEMALE ________ VSC Volleyball COED Teams ________ VFA Volleyball Free Agents ________ RSM Racquetball Singles MALE ________ RSF Racquetball Singles FEMALE ________ CHURCH:___________________ RETURN THIS FORM WITH CDYC REGISTRATIONS

by May 14, 2013

SR High CDYC competition totals Please complete this list, giving us the total number of entries in each category.

CDYC HOUSING – SR High

CHURCH_______________________________________________

This list is for: GUYS ROOMS GIRLS ROOMS Please list guys & girls on separate sheets.

PLEASE indicate sponsor by using an asterisk* beside their name!

Please suggest ONE person from your group that could be a floor super. Please print!

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

1____________________________________2____________________________________ 3____________________________________4____________________________________

Your Housing List must be postmarked by May 14th, 2013

T-shirt/Sweet Bag order form

SR HIGH CDYC 2013

CHURCH: ________________________________

Adult Sizes

TOTAL Order

t-shirt ONLY TOTAL Order

“sweet” bag, includes t-shirt, Cure Bible, and other goodies

Small Medium Large X-Large XX-Large TOTAL

Total @ $12 =______ Total @ $18 = ______

Please enter the TOTAL T-shirt/Sweet Bag Amount on the Registrar’s Report Form.

Please combine this with the Total Registration Amount

and sent in ONE CHECK, payable to CENTRAL REGION MYF.

Your Order Form must be postmarked

by May 14, 2013

CDYC GUIDELINES and things you should know…

Remember, as you are on the Indiana Wesleyan campus, that you represent your church and the entire Missionary Church. Therefore, you should always be on your best behavior and obey the rules for each area, including those set by your youth pastor or director!

REQUIRED SESSIONS: There are sessions everyone MUST attend. On the Program Schedule, these are in BOLD and ALL CAPS. Get your sleep at night so that you can wake up in time for the morning activities, and stay awake during the evening CDYC Celebrations! NO cell phones are allowed in the Celebration Sessions. Please turn them off and keep them “out of sight”.

RULES TO FOLLOW: 1. ANY INAPPROPRIATE BEHAVIOR will not be tolerated. Those involved will be disciplined, required to call their parents to explain their misbehavior, and/or be sent home at their own expense. If your behavior is unlawful, the local law enforcement agency will be contacted.

2. IWU and CDYC want to set a God-honoring standard concerning attire. This concern is based on moral issues (the Christian values of modesty). As a Christian, what is worn should NOT be immodest, provocative, or call undue attention to one’s self. Here are the guidelines for modesty that we are asking all conference attendee’s to follow: Please do not wear any tight-fitting garments, clothes of sheer material, extremely short shorts, halters, etc. Male guests are to wear shirts in all public places indoors and out. Finished sleeves (no cut offs) are required in the Rec. and Wellness Center. Female guests may not wear shorts, skirts, or skirts with slits that are above the finger tip length, when arms are at their side. Shirts and dresses that are strapless or have spaghetti straps are not appropriate. Low-clothing that reveals cleavage or more than a third of the back are not appropriate. Tank tops must have two-inch straps (bra straps or any other undergarment should not be showing) and may not be a sports bra tank top. At no time should the naval be showing (arms at side or raised). Midriff shirts are not appropriate. Female guests must wear one-piece swimsuits or wear t-shirts that provide appropriate coverage while at the swimming pool. In the event of questionable attire, CDYC staff will request sponsor assistance in bringing the student into compliance with dress code guidelines.

3. Your colored WRISTBAND is your meal ticket. Please attach it snugly to your wrist, so that it will NOT slip off. You must wear this all through CDYC in order to receive meals in the Baldwin Dining Room of the Student Center. Visitor meals MUST be purchased in the CDYC Office (PPAC Room 133). Replacement wristbands are available in the CDYC Office (PPAC Room 133) for $2.00.

4. THESE ARE PROHIBITED AT CDYC -- Alcohol, tobacco, drugs, skateboards, roller skates or blades, immodest clothing, immodest behavior, radios, CD players, iPods, 2-way radios, TVs, Nintendo-type games, computers, iPads, laser pointers, candles, incense, fireworks, weapons, water balloons, water guns, and disregard for the rules! 5. CDYC CAMPUS BOUNDARIES: For all CDYC participants, you must remain within the designated campus boundaries. These will be marked for you on a campus map and included in your CDYC

Program Booklet. Students may NOT leave the IWU campus. Failure to follow this rule WILL cause you to be sent home at your own expense!

LODGING: Here are a few important things about lodging in the dorms:

1. DO NOT sleep in the dorms if you did not register and pay for lodging. A vacant bed may be filled later in the day or week. If a friend wants to stay overnight, even to sleep on the floor, bring the friend to the CDYC Office to register and pay for lodging.

2. ABSOLUTELY NO guys on girl’s floors or girls on guy’s floors! NO EXCEPTIONS will be made for devotions, meetings, etc! Any student caught in the room of the opposite gender will be SENT HOME! There are a few married couples lodged in all dorms, so please be modest in the hallways!

3. BE IN YOUR OWN DORM no later than LOCK-UP TIME each night. Observe QUIET-TIME as stated on the program schedule after LOCK-UP until 6:00 AM. BE IN A DORM ROOM BY 1:00 AM. Be considerate of others even before and after that time. Counselors are to be the LAST ones in bed and the FIRST ones up...so have mercy on them! 4. LOCK YOUR ROOM. Each person should have a key to his/her room, and each roommate must be sure the room is locked when he/she is not there. Neither IWU nor CDYC are responsible for loss or damage of personal property. LOST YOUR KEY? You will forfeit your $10 deposit AND be billed $35 to replace the key. It is IMPORTANT to keep track of your key!!! 5. WINDOW SCREENS are NOT to be removed from dorm windows. Each violation will result in a fine. Sponsors will give instruction on the use of air conditioners in the dorm rooms.

6. ANY DAMAGE to dorm rooms, pillows, and IWU buildings and equipment will be charged to your youth group bill and the individual responsible will pay for the damages. Before leaving campus, please return dorm furniture to its original location. Bunked beds or missing furniture will result in additional fees charged to you after CDYC.

7. CLEAN YOUR ROOM, pick up litter, etc. on TUESDAY MORNING. Please see that your room is at least as clean as you found it upon arrival. YOU WILL BE RESPONSIBLE FOR DAMAGE/LOSS OF IWU PROPERTY.

8. CDYC and IWU are not responsible for lost or stolen items.

9. No food is to be ordered from off campus. Deliveries will not be allowed.

SPORTS OLYMPICS: Late registrants MAY add to an EXISTING team after the May 7th deadline, if there are open spots available on the team. Extenuating circumstances will be handled on a case by case basis…please call the Central District Office if you have any questions. SPORTS OLYMPICS AWARDS will be presented following individual championship matches/events throughout the week.

TALENT QUEST: Talent will be evaluated in over 20 different areas of music, art, speaking, and drama. Don't miss the exciting action in the PHILLIPPE PERFORMING ARTS CENTER (PPAC). Please do not move around or talk in the room when competition is occurring. Enter and leave quietly during the breaks.

If you register for Talent Quest, decide to “drop” and have not cancelled by June 1st or do not show for your performance, you have disqualified yourself from participating in that event the following year.

Because students are no longer required to perform or display Talent Quest entries at their local church, the Youth Pastor/Director or another youth sponsor needs to have seen/heard and approved all Talent Quest entries.

YOUTH GROUP MEETINGS: Times are scheduled for each individual youth group to get together. This will be required for all groups. See your Youth Leader for the exact location of your group meeting.

QUESTIONS ABOUT ANYTHING: DORM PROBLEMS? see these people in this order, please:

First -- See your SPONSOR. If that doesn't solve the problem, Second -- See the FLOOR SUPER. If that doesn't solve the problem, Third -- See the DORM SUPER. If that doesn't solve the problem, Fourth -- See the TOP SUPER BEN MASTEN

TALENT QUESTIONS? See Talent Quest Director MUSETTE ANDERSON in Phillippe Performing Arts Center in Room 137.

SPORTS OLYMPICS? See Sports Director MARK OUTCALT in the Concession Area of the Recreation & Wellness Center.

OTHER PROBLEMS? See someone in the CDYC Office Phillippe Performing Arts Center Room 133.

MESSAGES AND MAIL: Sponsors, please check for announcements, messages, or mail in the envelope attached to your church seating sign. For emergencies, the CDYC staff will do all they can to reach you immediately.

FIRST AID: The First Aid Room is located in the Coat Check Room in the Phillippe Performing Arts Center, off the main lobby area, and will be open 15 minutes before and after the morning and evening Celebration sessions. There will usually be a first aid person on duty in the PE Area when activities are scheduled there. They will be wearing RED CDYC FIRST AID t-shirts everyday.

SECURITY: CDYC has its own Security staff, in addition to IWU Security. If you have security problems, contact CDYC Security first.

SR HIGH CDYC STUDENT REGISTRATION

June 26-30, 2013 PLEASE fill out completely & legibly!

Church/City __________________________________ PLEASE COPY FORM BACK TO BACK Name ______________________________________ Male Female (First) (Last) Address _______________________________________________________________________ (Number & Street) (City) (State) (Zip) Phone (______) ________________ Birthdate ______________ Age _______ Grade _______ (current school year) I will participate in Live To Serve

REGISTRATION COSTS A – ENTIRE Registration of $____

by May 14, 2013 B – DEPOSIT of $60, by May 14th

w/$____ due by May 31, 2013 C – LATE Registration of $____

May 15 – 31, 2013 D – LATE Registration of $____

after June 1

ROOMMATE REQUEST

1. ____________________________________ (your name)

2. ____________________________________ Your youth director will make final housing assignments

for your youth group.

IWU will ONLY ALLOW 4 people per suite

To participate in an INDIVIDUAL talent or sport entry you MUST register by May 14.

CDYC and Indiana Wesleyan University Waiver/Release

READ CAREFULLY BEFORE SIGNING. DO NOT SIGN UNLESS YOU ARE WILLING TO RELEASE CDYC and INDIANA WESLEYAN UNIVERSITY (IWU) FROM LIABILITY.

I/We agree to abide by the CDYC Guidelines and will allow CDYC to share our contact information with Bethel College and Indiana Wesleyan University. I also give permission to have videotape or photographs taken of my son/daughter to be used for promotional purposes.

I, the participant, understand that the activities that take place in the IWU Recreation and Wellness Center, Troyer Sports Complex, and outdoor athletic fields are hazardous activities. The activities include but are not limited to swimming, diving, climbing, playing racquetball, running, jogging, walking, jumping, weight training, playing basketball, dodge ball or related activities, and use of related equipment hereafter referred to as “Activities”. The hazards inherent in these Activities include but are not limited to head and spinal injuries, eye or ear injuries, slips and falls, rope burns, cuts, concussions, strained muscles, broken bones, objects or persons falling on me, falling on objects or other persons, pulled muscles, near drowning, drowning, rope burns, mental and emotional trauma, and communicable diseases, and other hazards.

I further understand that these Activities involve a risk of serious injury and even death and caution is required. I assume all risks inherent in these Activities including the negligent or deliberate act of another person. I understand that the Activities mentioned above are purely voluntary and I participate in them of my own free will for my personal enjoyment. I am using the equipment and machinery with full knowledge and understanding of the risks involved. I hereby assume and accept any and all risks of injury or damage while participating in these Activities. I represent to IWU that I have the skills and ability to safely participate in these Activities and that any equipment that I furnish is in good condition, order and repair and is fit for and will be used for its intended purpose. I do hereby declare myself to be physically sound and suffering from no condition, impairment, disease, or other illness that would prevent or inhibit my participation in these Activities.

In consideration of my being permitted by IWU to participate in these Activities I, my heirs, successors, and personal representatives hereby release, discharge, indemnify, and hold harmless CDYC, The Central District of the Missionary Church, IWU, its Board of Trustees, officers, trustees, agents, and employees from any and all claims, actions, suits, costs, expenses, injuries or damages arising out of these Activities.

I certify that I have adequate insurance to cover injury or damage, including damage or loss to personal items, that I may cause or suffer while participating in these Activities, or else I agree to bear the cost of such injury, damage, or loss myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have. I consent to the provision of emergency medical treatment to the extent that the treatment is necessary in the opinion of a medical professional.

In consideration that the participant is a Minor, this Release remains in full force and effect and that by signing this Release, I affirm that I am the legal guardian of the Minor and agree and consent to this Release on behalf of said Minor. I hereby grant permission and authorize the provision of emergency medical treatment for minors or myself while becoming ill or injured in these Activities.

I have carefully read this Release. I fully understand the contents herein. I also understand that I can ask questions about this if I want. If any portion of this Release is held invalid, the rest of the document shall continue in full force and effect. The interpretation and performance of this Release shall be construed in accordance with the laws of the State of Indiana, and any litigation arising out of this Agreement shall be venued in the State of Indiana and shall be governed by the laws of the State of Indiana. List any medical problems, handicaps, allergies, or medications that should be taken into consideration on a separate paper. ____________________________________ ______________________________________

Student Signature Parent Signature

Date ________________________________________ Emergency Phone Number _______________________________ Health Insurance Co ___________________________ Policy Number _________________________________________

T-shirt size – Youth Group: XS S M L XL 2X 3X 4X

CDYC T-shirt only ($12) Yes NO “Sweet” Bag ($18) Yes

Talent Quest SR High Student Registration Form page 2

Participants must be of high-school age, remaining under 20 years of age, through 6/30/2013.

You may participate in TWO Individual/Small Group entries, THREE Large Group entries, and TWO Art entries. Please CIRCLE THE CODE for the events in which you will participate. Competition will take place Wednesday night and Thursday. PLEASE see Talent Quest Rules for entry details… Individual/Small Group Performance Large Group Performance (6 or More People) CODE CATEGORY CODE CATEGORY PR Preaching DLG Drama Large Group MS Motivational Speaking VLG Vocal Large Group ST Storytelling ILG Instrumental Large Group DR Dramatic Recitation ILG Instrumental Large Group (may enter twice, DG Drama Group (2-5 people) if different instruments are played) VS Vocal Solo CLG Creative Movement Large Group SAVS Self-Accompanied Vocal Solo VG Vocal Group (2-5 people) Art BS Brass Solo (Inst. _______________) CODE CATEGORY WW Woodwind Solo (Inst. __________) DP Drawing/Painting OS Orchestral Strings Solo (Inst. __________) PH Photography (one 8X10 or larger print) AG Acoustic Guitar Solo CW Creative Writing ES Electric Guitar/Bass Solo PO Poetry PS Pretuned Solo (Inst. ____________) VI Video PE Percussion Solo (Inst. ____________) VIG Video Group PI Piano Solo UA Unique Art (collages, sculpture, etc.) AC Accompanist, Piano/Guitar (Circle one) (Entry to be accompanied__________________) IG Instrumental Group (2-5 people) IG Instrumental Group (2-5 people, may enter twice, if different instruments are played) WB Worship Band CS Creative Movement Solo CG Creative Movement Group (2-5 people) ***********************************************************************************

Sports Olympics Participants must be of high-school age, remaining under 20 years of age, through 6/30/2013. SEE Sports Olympics

Rulebook for complete details for each category.

You may enter ONE of these sports AND ONE of these sports

(please, circle the CODE for the sport/sports you would like to participate in.) Basketball OR Racquetball and Table Tennis Volleyball or Soccer (Wed/Thurs) (Thurs) (Wed/Thurs) (Fri/Sat) (Fri)

CODE SPORT CODE SPORT BSM 3 on 3 Male Basketball Team VSC Coed Volleyball Team BSF 3 on 3 Female Basketball Team VFA Volleyball Free Agent RSM Male Racquetball Singles SSM Male Soccer Team RSF Female Racquetball Singles SMFA Male Soccer Free Agent TTSM Male Table Tennis Singles SSF Female Soccer Team TTSF Female Table Tennis Singles SFFA Female Soccer Free Agent

SR HIGH CDYC SPONSOR REGISTRATION June 26-30, 2013 PLEASE fill out completely & legibly!

Church/City _________________________________________________________________ Youth Director/Sponsor_________________________________ Male Female (First) (Last) Address ____________________________________________________________________ (Number & Street) (City) (State) (Zip) Phone (____) _________________ Age ___________ E-mail ______________________________________________________________________

REGISTRATION COSTS A – ENTIRE Registration of $230 by May 14

B – DEPOSIT of $60, with $170 due May 31

C – LATE Registration of $240 (May 14 -- June 1)

D – LATE Registration of $245 (after June 1)

Volunteers are needed: Please indicate an area that you might be willing to serve in at CDYC. PLEASE clear this with your youth director first! You will be contacted before CDYC, if we need your help.

Chaperon for Live To Serve Projects Sports Referee, specify sport ________ Volleyball Score Keeper Talent Quest Room Announcer Accompanist for Talent Entries



No









I have carefully read this Release. I fully understand the contents herein. I also understand that I can ask questions about this if I want. If any portion of this Release is held invalid, the rest of the document shall continue in full force and effect. The interpretation and performance of this Release shall be construed in accordance with the laws of the State of Indiana, and any litigation arising out of this Agreement shall be venued in the State of Indiana and shall be governed by the laws of the State of Indiana. List any medical problems, handicaps, allergies, or medications that should be taken into consideration on a separate paper. ____________________________________________

Sponsor Signature Date ________________________________________ Emergency Phone Number _______________________________

Health Insurance Co ___________________________ Policy Number _________________________________________

SR HIGH CDYC PART TIME REGISTRATION June 26-30, 2013 PLEASE fill out completely & legibly!

Church/City ___________________________________________________________________ Name ______________________________________ Male Female (First) (Last) Address _______________________________________________________________________ (Number & Street) (City) (State) (Zip) Phone (______) ________________ Birthdate ______________ Age _______ Grade _______ (current school year) Classification Student Sponsor Child Other_______________________________

Part Time REGISTRATION (1/2 of registration fee is non-transferable and non-refundable)

F (completed Freshman High School and under 20 years old through June 30)

Circle Nights on Campus: Wednesday Thursday Friday Saturday $65 X ______ Nights = $______

Part Time REGISTRATION (1/2 of registration fee is non-transferable and non-refundable)

G – for a CHILD 5-11 years old by June 30, 2012

Circle Nights on Campus: Wednesday Thursday Friday Saturday $30 X ______ Nights = $______










Student Signature Parent Signature Date ________________________________________ Emergency Phone Number _______________________________




No

SR HIGH CDYC CHILD REGISTRATION June 26-30, 2013 PLEASE fill out completely & legibly!

Church/City ___________________________________________________________________ Name ______________________________________ Male Female (First) (Last) Address _______________________________________________________________________ (Number & Street) (City) (State) (Zip) Phone (______) ________________ Birthdate ______________ Age _______ Grade _______ (current school year) Child will house with_____________________________________________________________

Full Time REGISTRATION (1/4 of registration fee is non-transferable and non-refundable)

E – Entire Registration of $85 For a CHILD 5-11 years old by June 30, 2012

NO charge for children who are younger than 5 years, if they eat from their parent’s meal portions and do NOT use a bed. If a bed is used, or if the child will have his/her own meals, register as “E” If the child is coming with a parent who is registered part time – please use the part time registration form.










Student Signature Parent Signature Date ________________________________________ Emergency Phone Number _______________________________


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