YOUTH RALLY 2008!
 Tucson, AZ  ê  April 25-27, 2008
 Youth & Advisor Registration Form and Permission Slip

Steps for Registration:
1.

Complete this Registration Form/ Permission Slip.  Please complete a form for each participant with all required signatures

 2. Complete the Southwest Conf. Medical Release Form (a new form is required each school year).  3.

Sign a copy of the Southwest Conference Youth/Advisor Covenant (reverse side).

 4.

Mail completed forms directly to: Southwest Conference UCC
4423 N. 24th St., Ste. 600
Phoenix, AZ  85016
All checks are payable to: Southwest Conference UCC

Please print in blue or black ink.

NAME

SEX

GRADE (youth)

AGE (youth and advisors)

ADDRESS

Is this your first Youth Rally?

q YES    q NO

CITY

STATE

ZIP

HOME PHONE 

PARTICIPANT CELL

PARTICIPANT EMAIL

CHURCH NAME

PARENT/GUARDIAN NAME                                                              

PARENT E-MAIL

ADDRESS (if different)

CITY, STATE, ZIP

HOME PHONE

WORK PHONE

CELL PHONE

EMERGENCY CONTACT (name)

PHONE

SPECIAL INSTRUCTIONS

VEGETARIAN MEAL PLAN?   q YES    q NO

TRANSPORTATION TO TUCSON NEEDED?   q YES    q NO

DO YOU REQUEST TRAVEL POOL ASSISTANCE?  q YES    q NO
Advisors: If you drive to the Youth Rally, how many, including yourself, can you transport in your vehicle?

 

u     I give my son/daughter (listed above) permission to participate in the Youth Rally 2008. 

____________________________________________________________________________________________

PARENT/GUARDIAN SIGNATURE (required)                                                                                 DATE

____________________________________________________________________________________________

YOUTH PARITICPANT OR EVENT ADULT ADVISOR SIGNATURE (required)                              DATE

____________________________________________________________________________________________

PASTOR’S SIGNATURE (required)                                                                                                    DATE

YOUTH RALLY FEES**

 êê   Early Registration by April 9: $50/youth; $25/advisors   êê
 Registration deadline Feb. 18:  $70/youth; $45/advisor
[COVERS: program materials, snacks, and 5 meals]
Transportation to Tucson Cost:      $50.00
** No one should be left out because of money.  Please ask about scholarships.