Registration is from 9 a.m. on Friday May 23 rd at the Baltimore Arena, Baltimore

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1 YYAC (Younger Teens) at Conference For youth in Grades 6,7 &8 Conference Annual Meeting Baltimore Arena, Baltimore Friday May 23 rd Sunday May 25 th, 2014 Information and Registration Form What s in it for you? The YYAC program is for youth in Grades 6 through Grade 8 to: share what excites you and energizes you about being part of the United Church participate in the Conference Annual Meeting and share in the discussion around decisions about the life and work of the United Church in Bay of Quinte Conference, especially about the future of the United Church of Canada meet with new people and celebrate the involvement and diversity of youth in the United Churches across the Bay of Quinte Conference discover and strengthen your leadership gifts and skills for ministry in your home congregation, the wider church, and world worship, play, and learn together Registration is from 9 a.m. on Friday May 23 rd at the Baltimore Arena, Baltimore Cost: $125 for first youth in a family $110 for second youth in a family $100 for third youth in a family Please make cheques payable to: Bay of Quinte Conference Please send your cheque, registration form, behavioural covenant and permission form to: Bay of Quinte Conference Box 700, 67 Mill St. Frankford, ON KOK 2C0 Registration Deadline: April 22 nd, 2014 Please note: sleeping place is limited so register early! For further information, contact: Jackie Harper, Conference Minister: Youth & Programs, Or by at: programs@bayofquinteconference.ca Registration form on reverse

2 YYAC Program - Grades 6,7 &8 s at Conference REGISTRATION FORM Please complete the Behavioural Covenant and Permission Form and return with this application. Name: Gender: Age: Grade: Address (please include street, town/city and postal code): Phone: - - address: Home Church: Presbytery: Tell us why you want to be part of the YYAC (Grades 6,7 &8) Program at Conference 2014: Please list any special interests: How are you involved in your congregation? (i.e. youth group, choir, outreach, church school, committee: I understand and agree to the expectation that I will attend the whole of the Grades 6, 7, & 8 Program 2014, from Friday May 23 rd 10a.m. to Sunday May 25 th, at 4p.m. Signature Signature of Parent Please mail completed forms, with your cheque to: Bay of Quinte Conference Box 700, 67 Mill St., Frankford, ON K0K 2C0 Please note: full refunds will be issued up to two weeks prior to the event (May 9 th, 2014), after that date the costs of meals will be deducted before any refund is offered. R

3 egistration Deadline: March 19, 2010 YYAC Younger Youth at Conference Permission Form Registration Deadline: April 22 nd, 2014 YAC (Please Print) I / We (parent / guardian name) give permission for (participants name) to participate in the Bay of Quinte Conference YYAC Program for youth in Grades 6,7 & 8. During the time of the event at Conference (May 23-25, 2014) I/we will be available by phone at the following numbers: Home: - - Work: - - Cell: - - (Please check off the permissions granted and sign the form at the bottom of the page.) PERMISSION TO PARTICIPATE (for those under 18 years of age): Permission is granted for our son/daughter to fully participate in the YYAC program at Conference of Bay of Quinte Conference, The United Church of Canada, to be held at the Baltimore Arena, Baltimore. Participation will include physical activities such as walking, games, outdoor activities, etc. Please list anything that would limit participation: SWIMMING PERMISSION Permission is granted for our daughter/son to participate in the swimming activity planned as part of the program. PHOTOGRAPH AND VIDEO RELEASE I give permission for the photograph and/or video image, of myself/my child, as taken by authorized persons, to be used as memory or promotional material in various United Church of Canada print and electronic resources, including online community locations and Bay of Quinte Conference web site for the promotion of Youth Forum and Youth Events in Bay of Quinte Conference of The United Church of Canada.

4 HEALTH INFORMATION: (Important: This information is necessary to participate in the Grades 6, 7, & 8 Program at Conference) Allergies: Medications: Special diet (i.e.) vegetarian): Current medication(s): Dosage and Frequency: Self Administered: or Administered by an adult: Special needs: Are there any medical conditions we should know about? Comments: please provide information about any physical, physiological or emotional needs that may require special attention by the leadership: Family Doctor: Phone Number: PERMISSION FOR EMERGENCY MEDICAL ATTENTION Permission is given for leaders or their designate to permit emergency treatment for my daughter / son if it is deemed necessary. All efforts will be made to contact the parent or guardian before permission for treatment is given. PERMISSION TO ADMINISTER NON PRESCRIPTION DRUGS: (such as Tylenol for headaches, etc.) Signatures: Parent / Guardian Name: Relationship to Participant: Signature:

5 Date: Behavioural Covenant YYAC, Youth Forum and Youth Events We are not alone, we live in God s world! Wherever two or three are gathered, God is present. (Matthew 18:20) When we gather, we have responsibilities: towards ourselves, towards the others with whom we gather, and towards God. It is our intent that all of the Bay of Quinte Conference YYAC Programs and Youth Events will provide a safe space for youth to participate and to grow in relationships with one another and with God. In order to accomplish this goal it requires the best intentions of all participants. We all have a role to play in helping to build a strong community. Certain behaviours contribute to the health of a community, while others can be unsafe and can create unhealthy tensions and breakdown in community. As participants in Bay of Quinte Conference YYAC and Youth Events, we will celebrate the incredible diversity of participants and strive to not discriminate against individuals on the basis of race, culture, colour, sexual orientation, gender identity, sex, abilities, age, class, and theological beliefs. I,, a participant in the Bay of Quinte Conference YYAC Program and Youth Event community, will participate in following the standards described in this covenant, and the standards that will be collectively created when the community gathers. I commit to upholding these standards, for the duration of the event. I understand that should I fail to adhere to these standards I may be removed from participation in the group, and/or required to return home. If a participant is sent home, the participant will not be eligible for a refund of fees paid. Signed: Date: Parent/Guardian Signature:

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