Youth Awakening Youth Awakening Registration Please choose one of the options below to register for Youth Awakening youth Registration form First Name *Last Name *Email Address *Phone *Gender *MaleFemaleAge 12-19 *Grade *T-Shirt Size *MediumX SmallSmallMediumLargeX Large2X Large3X Large4X LargeChurch Attending With (if any)I would like to stay at a HOST HOME (free) *NoNoYesEmergency Contact 1 Full Name *Emergency Contact 1 Phone Number *Emergency Contact 2 Full Name *Emergency Contact 2 Phone Number *Allergies/Special Medication InstructionsInsurance Information *Please enter the name and policy number for the participant's medical insurance company.Parental ReleaseI give my child permission to participate in all Youth Awakening 2025 activities January 24-26th, 2025 (or a possible postponed date due to inclement weather). I hereby assume all risks in connection with this entire event and I further hold harmless and release New Life Community Church (NLCC) from any claims, costs, judgments or liability for any injury, illness or damage that may occur while my child is attending the retreat. This release agreement also applies to travel to and from NLCC, and during the retreat (including Free Time Electives). I further give permission for any medical treatment deemed necessary by those in charge of my child, with the full understanding that I will be notified as soon as possible of any such necessity. Permission is also granted to use my child’s likeness, photographs and/or video and sound recordings for broadcast, publication or any lawful purpose. I also understand that typing my name below constitutes an electronic signature verifying that I am the participant's parent/legal guardian.Full Name *Consent *Yes, I agree to this this release agreementTodays Date *Participant's AgreementI understand that the rules outlined at Youth Awakening 2025 are in my best interest as they insure my safety, my good example and my total retreat enjoyment as well as that of all other participants. Therefore, I agree to abide by the standards of the retreat and understand that a serious willful violation could result in the contacting of my parent/guardian and possible removal from the retreat at their expense, with no refund of retreat cost. I also understand that typing my name below constitutes an electronic signature verifying that I accept this agreementFull Name *Consent *Yes, I agree to this this Participant's Agreement.Todays Date *Please select your payment option *Pay Online (Preferred)Pay Online (Preferred)Pay In-Person (Payment will be due upon entry to the event)***After submitting the form, you will be automatically redirected to the payment website if you chose Pay Online.If paying online, please enter the name on the billing account for the payment that will be used***After submitting the form, you will be automatically redirected to the payment website Submit Application *After submitting the form, you will be automatically redirected to the payment website If you choose online payments. Adult Registration Form First Name *Last Name *Email Address *Phone *Gender *MaleFemaleAge *T-Shirt Size *MediumX SmallSmallMediumLargeX Large2X Large3X Large4X LargeChurch Attending With (if any)Please select your payment option *Pay Online (Preferred)Pay Online (Preferred)Pay In-Person (Payment will be due upon entry to the event)***After submitting the form, you will be automatically redirected to the payment website if you chose Pay Online.If paying online, please enter the name on the billing account for the payment that will be used***After submitting the form, you will be automatically redirected to the payment website Submit Application *After submitting the form, you will be automatically redirected to the payment website If you choose online payments.