The Disciple Project

How to Register for The
Disciple Project
June 23-27, 2014
Texas Lutheran University, Seguin, Texas
Most registrations for The Disciple Project are done as a group.
The Primary Adult Leader registers all participants from their
congregation following the steps at right which include
collecting a signed Registration Worksheet from each person.
If you are registering as an individual adult, you do not need to
complete the Registration Worksheet before entering your data
online.
Youth/Adult Safety Ratio is 8 to 1 of same gender. Individuals must be
age 21 or older to be an adult leader.
Housing is gender-specific in the university dorms. Your congregation
will be assigned to a suite (or suites) and the adult leaders will
designate specific rooms within those suites after check-in.
In accordance with our Safe Haven Policy, youth may share a suite
with an adult, but not a room. It is imperative that groups with both
male and female youth have both male and female adult leaders
since they may be housed in different locations on campus. All
participants will need to bring bedding & towels, however linens are
available from the university for an additional fee.
First
Give a copy of the Disciple Project Registration
Worksheet, (available on the following pages in English or Spanish),
to each participant to gather the information you will need to
register online AND signatures on the Covenant and Releases.
Note: parents must sign releases if participant is under 18.
Next
Collect the completed, signed Worksheets from each
person. Go to http://lead.wildapricot.org/Events, select Disciple
Project, and register the Primary Adult Leader first. Then, one by
one, enter each additional person’s data from their worksheet.
Pay by credit card online or mail in a check.
Finally
Make a copy of each person’s completed
worksheet for yourself, and mail the originals with ONE check
payable to LEAD (or enclose a copy of credit card payment
receipt) to:
LEAD
12941 I-45 North Frwy, #210
Houston, TX 77060-1243
by the deadline listed below.
A confirmation email goes to the primary adult leader upon
registering. Additional info is sent via email and available at
waytolead.org in the weeks leading up to the event.
Cost:
$395 per person (includes meals, housing & program)
Deadline to register online Saturday, May 31, 2014.
Late Registration:
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Registration Fee includes housing, food,
trainers, materials, projects
&
fun!
After May 31, registrations
will be accepted on a space-available basis for $415.
Cancellation Policy:
Cancellations can be done
online by the Primary adult leader until May 31st. Once online
registration has closed, email your cancellation request to
[email protected]. Cancellations received on or
before Monday, June 2 will receive a refund (credit card fees
will not be refunded). No refunds will be made after that date;
however, substitutions may be made for $20 per person.
A TLU Health Form (available at waytolead.org) is required for
every participant. Bring the completed and signed Health
Forms to the event (do not mail). The TLU Health Forms will be
collected at registration check-in by the school nurse. Please
note that youth are required to turn in all medications to the
school nurse at registration check-in.
Questions:
Contact Amy Gulliksen, Registrar at
[email protected] or call 281-873-5665.
Last
Gender:

Male

Female
City & State
 Follow to LEAD
 Sports & Fitness
 21st Century Communication
Have you been to Disciple Project before? If so, which track did you take? ________________________________________
 Preaching
 Music & Worship
 Photography
I would like a Linen Pack (sheets, blanket pillow, towel) additional cost of $15
Choose One Track:
 Art
 Camp Hope
 Dance

Special Needs or Limitations:___________________________________________
Food or Environmental Allergies:_________________________________________
Safety Information
Cell Phone: __________________________
Work Phone:_________________________
Relationship: ________________________
Name: _____________________________
 Youth (under 18 years of age)
 Young Adult (18 to 21 years of age)
 Adult (over age 21)
Year
Home Phone:_________________________
Day
In case of emergency, contact
Check One:
Month
Date of
Birth: _______/______/_______
E-mail address:______________________________________________________
Home Phone: ________________________ Cell Phone: ______________________
City, State & Zip: ____________________________________________________
Participant’s Mailing Address: ___________________________________________
Congregation Name
Congregation: _______________________________________________________
Current Grade in School: ________
________________
Preferred Name
For Nametag: __________________________
First
Name:____________________
Personal Information—PLEASE PRINT
Please fill out this worksheet and sign where indicated. Give to your group’s Primary Adult
Leader who will enter all information online and enclose with the Confirmation email.
June 23-27, 2014
at Texas Lutheran University
Date
Parent or Participant (if age 18 or over )
Date
___________________________________________________________
Media Release: I, the undersigned, hereby give permission for LEAD and the
TX-LA Gulf Coast Synod to use, publish, or disclose in newsletters, brochures,
periodicals, posters, websites or other media related vehicles, any
photographs, videos, audios, and any other material in which either I, or my
minor child named at left, may have appeared, spoken, written, or otherwise
been represented. I understand that a copy of this release will be kept on file to
indemnify LEAD and the synod for use of the materials indicated.
Medical Release: I hereby authorize my congregation’s adult leader and/or an
event staff member to consent to and authorize the administration and
performance of all treatments that may be considered advisable or necessary
in the judgment of attending physicians, in the event that I, or my minor child
named at left, should be admitted to any hospital, or be in need of medical
treatment.
Liability release: I certify that the information described in this registration
form is accurate and complete to the best of my knowledge. I hereby release
LEAD, the TX–LA Gulf Coast Synod, and the sponsors from any legal or
financial responsibility with respect to participation in this event, or any known
element associated with the event, including transportation by charter bus,
rented van or private vehicle. I give permission for the distribution of the
participant’s address, e-mail addresses and phone numbers to others (LEAD,
synod teams, & TLU use only). I understand the implications of the Participant
Covenant.
Participant
___________________________________________________________
Participant’s Covenant:
MUST BE SIGNED BY EVERY PERSON ATTENDING EVENT!
By registering I am participating in an event which has as its purpose:
Christian worship, fellowship and growth. As a minor (under age 21), I will
refrain from using alcohol, tobacco or illegal drugs and I understand that no
smoking is allowed. As an adult (21 or over), I will show good judgment and
serve as a responsible role model in all aspects especially in regards to alcohol
consumption. Adult alcohol consumption is not allowed in the presence of
minors attending this event (other than for sacramental purposes). I will not
bring anything that could be considered dangerous (fireworks, knives, lighters,
etc.). I will participate fully in the event, honor time commitments and respect
the rights of others. I understand that failure to abide by this covenant will
result in consequences; one of which includes being sent home immediately at
my own expense.
LEAD
12941 I-45 North Freeway #210, Houston, TX 77060-1243
The Disciple Project Registration Worksheet/Covenant/Releases
Apellido


Grado Actual en Escuela: ________
Género:
Masculino Femenino
Ciudad y Estado
 Predicando
 Música y Culto
 Fotografía
 Como seguir para ser líder
 Deportes & Acondicionamiento Físico
 Comunicaciones del siglo 21
¿Ha asistido el Proyecto de Discípulo en años anteriores? Si es así, ¿cuál pista eligió?______________________________
Elige una pista:
 Arte
 “Camp Hope”
 Baile
 Me gustaría tener un juego de ropa de cama (sábanas, almohada, toalla) costo adicional de $ 15
Necesidades Especiales o Limitaciones:____________________________________
Información sobre seguridad
Alergias a Comidas o Ambientales:_______________________________________
Celular: ____________________________
Teléfono de Trabajo:__________________
Relación: __________________________
Nombre: ___________________________
 Joven (menor de 18 años de edad)
 Joven Adulto (18 a 21 años de edad)
 Adulto (Mayor de 21 años de edad )
Año
Teléfono de Casa:____________________
Día
En caso de emergencia, contactar a
Marque uno:
Mes
Fecha de
Nacimiento: ______/___/_______
Correo Electrónico:__________________________________________________
Teléfono: ________________________ Celular: __________________________
Ciudad, Estado y Código Postal: __________________________________________
Dirección del Participante: _____________________________________________
Nombre de la Congregación
Congregación: _______________________________________________________
Nombre preferido
para etiqueta: _________________________
Nombre
Nombre:____________________ ________________
Información Personal—EN LETRA DE MOLDE
Por favor, llene este formulario y firme donde se indica. Dar a su líder adulto que entrará toda la información
por internet, y luego incluirlo con la confirmación de registro.
LEAD
12941 I-45 North Freeway #210, Houston, TX 77060-1243
23-27 de junio de 2014
en Texas Lutheran University
Fecha
Padre o Participante (mayor de 18 años)
Fecha
___________________________________________________________
Comunicado de prensa: Yo, el abajo firmante, doy permiso a LEAD, el Sínodo de
la Costa del Golfo TX-LA de utilizar, publicar, o divulgar en los
boletines, folletos, revistas, carteles, páginas web u otros medios relacionados
con los vehículos, las fotografías, videos, audios y cualquier otro material en
el que yo, o mi hijo menor de edad nombrado a la izquierda, puede
haber aparecido, hablado, escrito o de otra manera presentado.
Entiendo que una copia de este comunicado se mantendrá en los archivos para
indemnizar a LEAD y el sínodo para el uso de los materiales indicados.
Exención Médica: Por la presente autorizo al líder adulto de mi congregación y / o
un miembro personal del evento de dar consentimiento y autorizar a la
administración y el rendimiento de todos los tratamientos que se pueden
considerar conveniente o necesario, a juicio de los médicos asistentes, en el caso
de que yo, o mi hijo menor de edad nombrado a la izquierda, deba ser admitido
en cualquier hospital, o estar en necesidad de tratamiento médico.
Exención de Responsabilidad: Yo certifico que la información descrita en este
formulario de inscripción es correcta y completa a lo mejor de mi conocimiento. Yo
libero a LEAD, el Sínodo de la Costa del Golfo TX-LA, y los patrocinadores de
cualquier responsabilidad legal o financiera con respecto a la participación en
este evento, o cualquier elemento conocido asociado al evento, incluyendo el
transporte en autobús, alquiler de furgoneta o vehículo privado. Doy permiso para
que la distribución de la dirección del participante, las direcciones de
correo electrónico y números de teléfono a los demás (uso único de LEAD,
equipos del sínodo, y TLU). Entiendo las implicaciones del pacto de participantes.
Participante
___________________________________________________________
Pacto del Participante:
ĺDEBE SER FIRMADO POR CADA PERSONA ASISTIENDO AL EVENTO!
Al registrarme estoy participando en un evento, que tiene como propósito: el culto
cristiano, la comunión y el crecimiento. Como menor de edad (menores de 21
años) me abstendré de consumir alcohol, tabaco o drogas ilegales y
entiendo que no se permite fumar. Como un adulto (de 21 años o más) voy
a mostrar el buen juicio y servir como modelo de
conducta responsable en todos los aspectos, especialmente en cuanto al consumo
de alcohol. El consumo de alcohol para adultos no está permitido en la
presencia de los menores que asisten a este evento (que no sean para uso
sacramental). No voy a traer nada que pueda considerarse peligroso (fuegos
artificiales, cuchillos, encendedores, etc.) Voy a participar plenamente en el
evento, cumplir los compromisos de tiempo y respetar los derechos de los demás.
Entiendo que el no cumplir con este pacto dará lugar a consecuencias; uno de los
cuales incluye ser enviado a casa de inmediato por mi cuenta.
Pacto, Extensiones, y Registro del Proyecto de Discípulo