2018 Encore Registration - Youth
UCUMC | July 23-27 | 9am-2:00pm

Please complete one registration for each Youth Counselor. To be filled out with/by parent/guardian.


YOUTH INFO


VOLUNTEER INFO


PARENT/GUARDIAN INFO
**used for communication and confirmation emails - check for typos**


ADDRESS


YOUTH MEDICAL INFO


EMERGENCY INFO


*PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



*RELEASE

Submitting this on-line form will be the equivalent of signing a paper registration form.

  • I have read and understand the above information. The information I have given UCUMC is accurate and true to the best of my knowledge.
  • My electronic signature signifies my understanding that submitting this online form will be the equivalent of signing a paper registration form.

 



When this form is processed, you will receive a confirmation email. Thank you!