the Registration Form Here!

Middle School Retreat to
Ocean City, MD
ALIVE 2014
~
GAME ON
N ovem ber 21-23, 2014
Ocean City Convention Center
Ocean City, Maryland
H OPE’s You th Ministry
No v e m b e r 2 1 -2 3 , 2 0 1 4
PO BOX 914
700 Cooper Rd.
Voorhees, N J 08043
Cost ... $135.00 for the entire 3 d ay w eekend . Which inclu d es conference fee, all related events, 2 nights lod ging in Ocean City, MD, transp ortation, breakfast both
d ays and great w orship and fu n. You w ill need to bring
extra $ for fast
food type meals—2 lunches and 2 dinner. Breakfast each d ay w ill be p rovid ed .
$85.00 non-refu nd able registration d u e to Dave’s
m ailbox in the office by October 9, 2014, p erm ission slip m u st
be inclu d ed w ith d ep osit. There is a $25 late fee for registrations received after this d ate (becau se
conference costs go u p ).
Confidential Financial Scholarships are available-see Dave.
Balance is d u e no later than N ovem ber 2, 2014.
What to bring . . .
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Bible, pen or pencil
Warm comfortable clothes (really, it w ill be COLD !)
Pajamas
Toiletry stuff
Spending $ for 2 lunches and 2 dinner and an afternoon on the boardw alk.
2 meals at McD onalds (Friday D inner & Sunday Lunch)
Lunch on the boardw alk… w hatever you w ant to eat
$5 for Saturday’s Pizza D inner
What NOT to bring . . .
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Cell Phones,
Drugs, alcohol, cigarettes, tobacco, fireworks (Duh!)
Shaving cream (We expect to see hairy faces and legs!!)
Balloons, etc.
A B AD ATTITUDE
Important rules . . .
1.
2.
3.
4.
5.
Love God w ith all your heart, mind, soul, and body.
Treat others the w ay you w ould treat yourself.
Relax, be flexible. N o grumbling or complaining.
Smile a lot.
Be nice to D ave!
ALIVE 2013…
ALL IN!
a middle school youth conference
Featuring…
RUN KS (SPEAKER) - Fu nny nam e. Fu nny gu y. Whatever teenagers are d ealing
w ith in their lives,Ru nks talks abou t it. The w ild ly p op u lar Ru nks has a u niqu e gift
for relating to teenagers, com m u nicating the tru th in a d ynam ic, hu m orou s, and
above all relevant m anner that hold s their attention and fires their im agination. H is m essage challenges his listeners to engage their m ind s in their faith,
equ ip p ing them to have a reason and not an excu se for believing in the tru th. H e is
a m aster at u sing hilariou s stories to illu strate Biblical tru th w ith clarity, au thority,
and d ep th. As one you th p astor w rote: ”Ru nks is a 6’6”, red -head ed , A.D.H .D. kid
m agnet w hose m essage has the hu m or of a stand -u p com ed ian and the d ep th of a
theologian.” w w w .ru nks.com
TYRA LOKEY (SPEAKER) - Grow ing u p in an abu sive and broken fam ily environm ent, one in w hich she had to search d u m p sters for food , Tyra learned at an early
age that the one p erson w ho tru ly loved her and on w hom she cou ld d ep end w as
Jesu s. Tyra travels all over the w orld , sp eaking and u sing sign langu age, sharing
her “m ess” and how God m ad e it her m essage. w w w .tyralokey.com
THE M USEUM (W ORSH IP BAN D ) - Fou r short years ago, five Alabam a boys exp lod ed
into the m u sic ind u stry w ith their d ebu t, self-titled albu m , Rush of Fools. Qu ickly
gaining national recognition w ith their m assive hit single, “Und o”, along w ith fou r
Dove aw ard nom inations, the band w as on fire, only to soon be p u t throu gh the fire
w ith som e incred ible challenges, and be transform ed throu gh them . They m aintain
that the love story of God changes everything, and they w ant to share this throu gh
their m u sic, so others can sing w ith them .
w w w .ru shoffools.com
D AVE THE H ORN G UY (EN TERTAIN ER) – D AVE EN N S’ IS A MUSICIAN ’S MUSICIAN AN D
A GUY WITH A LOT OF H ORN S. H IS IN N OVATIVE SPIRIT AN D MUSICAL GEN IUS H AVE LED
H IM TO PERFORM ALL OVER TH E COUN TRY, FROM TH E TON IGH T SH OW WITH JAY LEN O
TO MAJOR SPORTIN G EVEN T H ALF TIME SH OWS AN D N ATION AL EVEN TS.
WWW .DAVETH EH ORN GUY.COM
REGISTRATION FORM
Student’s Name
Address:
Cell #
Age
Gender
Grade in school
I agree to abide by the rules of HOPE’s Youth Ministry and of ALIVE 2014.
I understand that if I am unable to obey these rules I will be asked to leave and my
parents will be responsible to provide transportation home.
Student signature
ALIVE 2014
~
GAME ON
CONSENT FORM
HOPE United Methodist Church - Youth Ministry
Participant’s Name
Birth Date
To HOPE’s Youth Program:
The undersigned does hereby give permission for our (my) child, ________________________, to
attend and participate in activities sponsored by HOPE Church on (date)
November 21-23, 2014
.
We (I) authorize an adult, in whose care the minor has been entrusted, to consent to any x-ray
examination, anesthetic, medical, surgical, or dental diagnosis or treatment, and hospital care, to be
rendered to the minor under the general or special supervision and on the advice of any physician or
dentist licensed under the provisions of the medical practice act on the medical staff of a licensed
hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said
hospital.
The undersigned shall be liable and agree(s) to pay all costs and expenses incurred in
connection with such medical and dental services rendered to the aforementioned child pursuant to this
authorization.
Should it be necessary for our (my) child to return home due to medical reasons or otherwise,
the undersigned shall assume all transportation costs.
The undersigned does also hereby give permission for our (my) child to ride in any vehicle
designated by the adult in whose care the minor has been entrusted while attending and participating in
activities sponsored by HOPE United Methodist Church.
Insurance Company
Policy #
Emergency Phone #’s
ask for:
ask for:
Any allergic reactions?
Student’s Signature:
Mother’s signature/date
Father’s signature/date
ALL SIGNATURES REQUIRED
Participant Disclaimer, Assumption of Risk and Waiver
(NOTE: this form should be signed and attached to all volunteer registration forms, event and activity
registration forms and employment applications)
I declare that all the information given by me in this application/registration is true and complete to the best of
my knowledge. I hereby give permission to representatives of HOPE United Methodist Church (“HOPE”) to
investigate and verify all information given in this application/registration form. I give my permission to have
employers past and present, law enforcement, and personal references disclose information related to my
fitness for service with HOPE. I give consent to HOPE to conduct a criminal background check and to review
my driving records. I hereby release and agree to hold harmless HOPE, its trustees, leadership team members,
officers, employees and volunteers, and any person or organization that provides information for or to HOPE
concerning me, or any attempt to verify, the information provided in this application.
I agree that my application/registration may be denied for any reason, or no reason, and HOPE reserves
exclusive right to determine the fitness of its volunteers and employees. I agree that the HOPE may deny my
application, or terminate my service at any time with or without cause, and is under no obligation to disclose its
reasons for doing so.
In consideration of being allowed to participate in any way in HOPE’s programs, activities and events, the
undersigned acknowledges, appreciates, and agrees that:
1.
Certain programs, activities and events (including, but not limited to work groups and construction
projects, sports activities, games, travel, hiking, biking, swimming, kayaking, climbing, sailing, boating, science classes/demonstrations, theatrical productions, etc.) of Hope involve risk, including the
potential for permanent injury, paralysis and death; and
2.
I knowingly and freely assume all such risks, both known and unknown, even if arising from the
negligence of others, and assume full responsibility for my participation; and,
3.
I willingly agree to comply with the conditions of participation in any particular program, activity or
event. If, however, I observe any unusual significant hazard during my presence or participation, I
will remove myself from participation and bring such to the attention of the nearest official immediately; and,
4.
I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby
release and hold harmless the HOPE United Methodist Church, its trustees, leadership team members, officers, officials, agents, employees, volunteers and affiliates with respect to any and all injury,
disability, death, or loss or damage to person or property, to the fullest extent permitted by law,
whether arising from negligence or otherwise.
I HAVE READ THE ABOVE DISCLAIMER, ASSUMPTION OF RISK AND WAIVER AND FULLY UNDERSTAND THE TERMS SET FORTH THEREIN. I UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL
RIGHTS BY MY SIGNING THIS FORM AND AGREEING TO THESE TERMS, AND I SIGN THIS FORM AND
AGREE TO THESE TERMS FREELY AND VOLUNTARILY AND WITHOUT INDUCEMENT FOR MYSELF.
Participant Signature
Date
Parent/Guardian Signature (if under 18)
Date
We will be staying at the Princess Bayside Hotel in Ocean City, Md.
The hotel provides bedding and towels.
Tentative Schedule
FRIDAY
4:00pm
Leave from HOPE Church, dinner on the way
9:00pm
General Session I
11:00pm Small Groups at Hotel
SATURDAY
8:00am
9:00am
11:00am
12:30pm
6:00pm
7:00pm
9:00pm
11:00pm
Breakfast – get ready for the day!
General Session II
Breakouts
Boardwalk, Lunch, Free Time
Pizza Dinner
General Session III
Concert & Exhibition Hall Open
Small Groups
SUNDAY
8:00am
9:15am
10:30am
12:00pm
3:30pm
Breakfast – get ready for the day!
Breakouts
General Session IV
Head Home, lunch on the way
Arrive back at the church
For more info on the conference, check out the Alive Website:
alive.mmyfc.org