Summer Conference 2019 Registration Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

We're glad you are coming to Summer Conference! Please fill out the following information to complete your registration. If you haven't already paid, please do that first, as your registration is considered invalid without that.

Email *

Information About You

First Name *

Last Name *

Phone Number *

XXX-XXX-XXXX

Dorm/Apartment Name & Room # *

(or local address if off-campus)

Gender *

Current Year *

For the 2018-19 school year

Is this your first time at Summer Conference? *

Preferred Payment Method *

Venmo @ivtcf

PayPal (credit card)

Cash

Check

Other:

Venmo Handle

Ex: @yourname

Have you gone through Mark 2 with TCF before? *

If you don't know what we mean, mark no.

How did you hear about Summer Conference? *

Who told you about it?

Spiritually, you consider yourself... *

Check all that apply

Agnostic

Atheist

Buddhist

Catholic

Christian

Hindu

Jewish

Muslim

Not Sure / Figuring things out

Other:

Required

Ethnically, how do you identify? *

Choose all that may apply.

Black / African-American

Hispanic / Latino

Middle Eastern

Native American / Indigenous (including Native Alaskans)

Pacific Islander / Native Hawaiian

East Asian (Japanese, Chinese, Korean, Mongolian, etc.)

South Asian (Indian, Sri Lankan, Pakistani, etc.)

Southeast Asian (Thai, Filipino, Vietnamese, Singaporean, Indonesian, etc.)

White / Caucasian

Other:

Required

Transportation

We'll be driving down to the dock together, and we'd like to know if you can help!

Are you able to drive people to and from the conference? *

If so, how many seatbelts does your car have? *

Don't forget to include yourself!

Emergency Information

Name of Emergency Contact *

What is their relationship to you? *

(e.g. Father, Sister, etc.)

Emergency Contact Phone Number *

Medical Insurance Company Name

Medical Insurance ID Number

(sometimes this is called the policy number)

Other Information

Are you allergic to anything? Do you have any dietary restrictions (not preferences)?

(e.g. food, medications, etc.)

Are you currently taking any medications? If so, which ones?

Housing and Storage: *

Check all that apply

I can help store luggage for other students from the end of school until coming back from Summer Con

I can help house people from the end of school until Summer Con

I need a place to store my luggage until the end of Summer Con

I need a place to stay from the end of school until Summer Con

I need a place to stay for a day or two after Summer Con until my flight date

None of the above

Required

I agree to the InterVaristy Release Agreement *

INTERVARSITY CHRISTIAN FELLOWSHIP RELEASE AGREEMENT 1. In consideration for being accepted and allowed to participate in this conference/project and activities associated with its program and location, I personally assume responsibility for my actions, and release InterVarsity Christian Fellowship/USA® (hereafter InterVarsity®), its Trustees, employees and agents from loss, injury or damage to myself or my property; provided that nothing contained herein shall excuse InterVarsity, its Trustees, employees or agents from responsibility to act with reasonable care for the safety of myself or my property. 2. I give permission to InterVarsity to be photographed, recorded, and/or video taped and to allow this material to be used for publicity. 3. I give permission to InterVarsity to obtain medical assistance in the event of an emergency. This permission will include the administration of medicines, surgical treatment, X-ray examination or hospitalization as might be ordered by a licensed medical doctor. I release and discharge InterVarsity, its trustees, employees, and agents from any liability for any first aid rendered or treatment performed pursuant to this consent. 4. I understand that InterVarsity has a hostage policy that states that InterVarsity should not yield to demands, including the payment of ransom or other extortion, issued through the use of hostage taking or extortion. 5. If I am under age 18, I state that I am a mature minor (of college age and living away from parent/guardian) and have the capacity to consent to the terms of this Release. 6. Any claim or dispute arising from or related to this release shall be settled by mediation and, if necessary, legally binding arbitration in accordance with the rules of a mutually agreed upon alternative dispute resolution service. Judgment upon an arbitration decision may be entered in any court otherwise having jurisdiction. These methods shall be the sole remedy for any controversy or claim arising out of this release and I expressly waive my right to file a lawsuit in any civil court against InterVarsity for such dispute, except to enforce an arbitration decision. I certify that I am competent to sign this Release, and have done so voluntarily.

I agree

Required

Notes / Questions?

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms