Winter Youth Conference 22 - Calvary Chapel South Pittsburgh

Winter Youth Conference

January 15th

Days

Hours

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SIGN-UP TODAY

ONE-DAY YOUTH CONFERENCE

Narrow Way Ministries is excited to announce:

This is a One-Day Youth Conference for ages 6th-12 grade filled with relatable teachings, games, workshops, Q&A’s, vendors, and food!

We hope that you will consider joining us/or sharing with friends and family. It matters for eternity!

INFO:

Age Group: 6th-12 grade

When: January 15th

Time: 12-7pm

Where: Calvary Chapel South Pittsburgh

Cost: $15.00 (Due at the Door)

Got Questions or Need Assistance?

Calvary Chapel South Pittsburgh
Phone: (412) 656-1304
Email: nwm@calvarysouthpitt.com

REGISTRATION FORM

STUDENT INFORMATION

First Name

Last Name

Phone

Mailing Address

City

State

Zipcode

Current Age?

Select a Shirt Size

PARENT/GUARDIAN INFORMATION

Parent/Guardian First Name

Parent/Guardian Last Name

Phone

(If two Parent/Guardians please fill in info for both below)

Parent/Guardian #2 - First Name

Parent/Guardian #2 Last Name

Phone

MEDICAL INFORMATION
For your peace of mind (and ours) we feel it is appropriate to ask you to provide the following personal details to allow us to meet your needs to the best of our ability. This will not affect your acceptance into the program.

Allergies

limitations

Dietary

Additional Medical info?

EMERGENCY CONTACT

First Name

Last Name

Phone #

ACKNOWLEDGMENTS

acknowledge1

I Acknowledge that it is my responsibility to ensure that I have made adequate provision to meet any known medical conditions (i.e. medication, inhalers, epi-pen, etc.)

Medical Acknowledgment 2

I Acknowledge there is a Hospital and Urgent Care are within a 1-4 miles of the facilities surrounding the program and will be taken to one of these locations if care is determined by Event Staff.

Medical Acknowledgment 3

I Acknowledge there is a hospital and Urgent Care are within a 1-4 miles of the facilities surrounding the program and will be taken to one of these locations if care is determined by Event Staff.

Medical Acknowledgment 4

I Acknowledge that I am the parent or legal guardian of the minor participant identified as Student in this form.

Medical Acknowledgment 5

I Acknowledge that I understand that during the program, photographs may be taken and videos may be produced and used for future publicity.

Medical Acknowledgment 6

I give permission for photographic images and videos of my child captured during the NWM program, to be used for the purposes of NWM, including in promotional materials and publications and I waive any rights of compensation or ownership thereto.

Parent/Guardian's Name:

Date (mm/dd/yy):

Your Email

Your Phone #

Got Questions or Need Assistance?

Calvary Chapel South Pittsburgh
Phone: (412) 656-1304
Email: nwm@calvarysouthpitt.com