September - IdentityYouthConference.ca

Participant/Leader/Parent/Guardian Waiver & Indemnity Agreement
IN CONSIDERATION OF being permitted to participate in Identity 2013, I, the undersigned
participant hereby release and undertake and agree to save harmless and keep
indemnified The Evangelical Free Church of Lethbridge, its principals, officers, agents,
officials, servants, organizers, and representatives from and against all claims, actions,
costs and expenses and demands whatsoever in respect of death, injury, loss or damage
to my person or property, howsoever caused, arising out of or in connection with my
participation in Identity 2013 and regardless of whether same may have been contributed
to or occasioned by the negligence of The Evangelical Free Church of Lethbridge, its
principals, officers, agents, officials, servants, organizers, and representatives.
September
28-30
I understand and agree that the activities involved in Identity 2013 may include, but are
not limited to paintball, 3 on 3 basketball, 5 on 5 basketball, skate park, go-carts, minigolf, dance and drama workshops, video games, swimming, driving range and a spa
experience. I understand that there may be an inherent danger in participation of these
activities and it is not possible to make these activities completely safe or free from risk. I
willingly accept all the risks and dangers therein.
If the participant is under eighteen (18) years of age, in consideration of the Participant
being permitted to engage and take part in Identity 2013 being offered, carried on,
sanctioned, or sponsored by The Evangelical Free Church of Lethbridge, the undersigned
Parent or Guardian of the Participant hereby releases and undertakes and agrees to save
harmless and keep indemnified The Evangelical Free Church of Lethbridge, its principals,
officers, agents, officials, servants, organizers, and representatives from and against all
claims, actions, costs and expenses and demands whatsoever in respect of death, injury,
loss or damage to the person or property of the Participant, howsoever caused, regardless
of whether same may have been contributed to or occasioned by the negligence of The
Evangelical Free Church of Lethbridge, its principals, officers, agents, officials, servants,
organizers, and representatives.
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Identity Youth Conference | SEPTember 27-29 |2013
E-Free Lethbridge
The Parent/Guardian and the Participant understand and agree that the activities involved
in Identity 2013 may include, but are not limited to paintball, 3 on 3 basketball, 5 on 5
basketball, skate park, go-carts, mini-golf, dance and drama workshops, video games
swimming, driving range, and a spa experience. The Parent/Guardian and the Participant
understand and agree that participation in these activities may involve an inherent danger
and it is not possible to make these activities completely safe or free from risk. The Parent/
Guardian and the Participant willingly accept all the risks and dangers therein.
It is hereby acknowledged and agreed that the contents hereof are fully understood by the
Participant (and Parent/Guardian) who agree(s) that same shall be binding upon (his/her/
their) heirs, successors, executors, administrators and assigns.
Jeremy Light
DAN BREMNES
LELAND KLASSEN
JOE GOSLIN | Jeff Goring
R2DJ
JOSH WORSFOLD | JOSIAH JOHNSON
PHOTOGRAPHIC PERMISSION:
I hereby grant permission to Identity 2013 and the Evangelical Free Church of Lethbridge
to photograph and/or video record the participant for event and general church use
including, but not limited to, highlight videos, photodirectories and website galleries.
Parent/Guardian Signature
Parent/Guardian Name
Witness Signature
Participant/Leader Signature
Date
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CMYK / .eps
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CMYK / .eps
Identity Youth Conference
@identity_LA
@identityyouthconference
When is it?
September 27-29, 2013
Registration opens June 1, 2013.
Check In begins Friday, September 27
@ 4:00pm and the conference ends
Sunday at 10:30am.
What does it cost?
$65: June 1 - August 1
$80: August 1 - September 20
$95: After September 20
$25/Leader
*Some activities may cost extra.
(ask your youth leader for details)
Where is it?
Evangelical Free Church of
Lethbridge
Phone Brody at 403.329.3125, check www.identityyouthconference.ca or email
[email protected].
Activites
This is how it works: When you arrive on Friday and register with your youth group
or small group, there will be a bunch of activities to sign up for. You can sign
up for TWO of these activities. There are limited spaces for these activities.
You might want to decide which activities your group is going to choose before
you arrive so you can go quickly to the station and get your names in a time slot
- they’ll fill up fast! You don’t have to sign up for activities...there are lots of open
activities that don’t require sign up....just show up and have fun!
Paintball
Dodgeball
Spa Experience
(girls only)
Laser Tag
3 on 3 Basketball
5 on 5 Ball Hockey
Grass Volleyball
Mini Golf
Driving Range ($)
Go Karts
Par 3 Golf ($ & bring
your own clubs)
Swimming ($)
Open Activites
Inflatables
Breakdance Workshop
RC Cars
Coffee Bar
Slackline
Climbing Wall
Skate Park
Artrageous
Board Games
StudentLeader
Address
City/Town
Birth Date
DD
Province
MM
YYYY Email
Phone #
What’s included?
All sessions and events are included
in the registration fee. Supper on
Friday, and lunch and supper on
Saturday are also included.
*Breakfasts are not provided.
(ask your youth leader for details)
Please select:
Name
Where will we sleep?
Accommodations are not provided.
Talk to your youth pastor
What if I have questions/concerns?
If you have questions about Identity, financial concerns or need assistance with
sleeping arrangements, please contact us, and we will do our best to help you.
Sign Up Required
Student/Leader
Registration Form
Who is it for?
It’s for students grade 6-12.
Postal Code
Grade (as of Sept 2013)
Church Name:
Youth Pastor:
Small Group Leader (if applicable):
Detach the form and keep the info sheet.
Information
If participant is under 18:
Name of Parent or Guardian
Phone #
Email
Health Care Number
Allergies/health concerns
Family Doctor
Phone #
Emergency Contact Person
Phone #
Relationship
Extra Fee Activities: (please add to registration amount)
I would like to add $6 for swimming
I would like to add $5 for the driving range
I would like to add $11 for the 9 hole (par 3) golf
Total Registration = $
+ $
base registration
=$
extra fee activities
TOTAL
Go to www.identityyouthconference.ca
for more information & to register.
You can also register by mail or in person:
*Activites are
subject to change
Evangelical Free Church of Lethbridge
4717 24th Ave. South, Lethbridge, AB T1K 7C1
Please make all cheques payable to the Evangelical Free Church of Lethbridge.