Encounter Conference 2021 Leader Registration

HERE.WE. GO. Encounter Conference 2021 will be a 3 day experience you will never forget. We are looking forward to all that God is going to do in the lives of our students during this fun-filled summer conference.

Please fill out the form completely. Shortly before Encounter 2021 kicks off, we will have an informational meeting where you will receive a leader handbook with the information you will need to know for the week. We ask that you do attend this meeting if you are planning on serving at Encounter Conference 2021.

If you have any questions, please contact us at encounterconference@lifeatvictory.com. We will be glad to address any questions or concerns that you may have. Thank you for your commitment!

This form is for Encounter Conference 2021. It will be held at Victory Family Church's Cranberry Campus. It is for 5th-12th grade, and will run June 23-25th, 2021

*First Name

*Last Name

*Email Address

*Phone Number

*Address Line 1

Address Line 2

*City

*State/Province/Region

*Zip/Postal Code

*I am a leader at::

*Gender:

*I will be over 18 at the time Encounter Conference 2021 begins:

*Adult T-shirt Size:

Parent/ Spouse (First, Last) Name:

Parent/ Spouse Cell #:

Parent/ Spouse Work #:

*Do you have any allergies:

YesNo

If yes, please list:

Current medications (if you have symptoms, bring medicine):

Reson for taking medication:

*Encounter Conference Waiver
I, on behalf of myself, my personal representatives, and my heirs, hereby voluntarily agree to release, waive, discharge, hold harmless, defend, and indemnify Victory Family Church and its staff, servants, and agents (employed or volunteer) from any and all claims, actions, or losses for bodily injury, property damage, wrongful death, loss of services, or otherwise which may arise out of my child’s participation in the activities revolving around the conference. I specifically understand that I am releasing, discharging, and waiving any claims or actions that I may have presently or in the future for negligent acts or other conduct by the staff, servants, and agents (employed or volunteer) of Victory Family Church. I have read the above waiver and release and by signing it agree that it is my intention to exempt and relieve Victory Family Church from liability for personal injury, property damage, or wrongful death caused by negligence or any other cause. I hereby give permission for the church staff or sponsor to obtain the services of a licensed physician for me in the event of an emergency where medical treatment is required. I agree to pay for any and all medical expenses incurred as a result of the use of this consent. I understand that it is my obligation to inform the management of Victory Family Church of any and all health considerations or medical conditions that would restrict my participation in any and all activities while at Encounter Conference.

*Mandated Reporter Policy As a Dream Team member who works with students I am by law required to report cases of abuse to CWIS. If I should witness or be told of an abusive situation I will report it to the Middle School Pastor / Director immediately, who will then assist me in filing a claim with CWIS. CWIS will then take over all parts of the investigation and due to the confidentiality policy, I will not talk to others about the case, nor confront any party belonging to the case. I understand that all information regarding a CWIS case is private and confidential, and I will respect the privacy of all parties involved.
I have read and understand this document and agree to all of the terms included herein.

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