Summer Conference 2019 Registration Form
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 address *
Information About You
First Name *
Your answer
Last Name *
Your answer
Phone Number *
XXX-XXX-XXXX
Your answer
Dorm/Apartment Name & Room # *
(or local address if off-campus)
Your answer
Gender *
Your answer
Current Year *
For the 2018-19 school year
Is this your first time at Summer Conference? *
Preferred Payment Method *
Venmo Handle
Ex: @yourname
Your answer
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?
Your answer
Spiritually, you consider yourself... *
Check all that apply
Required
Ethnically, how do you identify? *
Choose all that may apply.
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 *
Your answer
What is their relationship to you? *
(e.g. Father, Sister, etc.)
Your answer
Emergency Contact Phone Number *
Your answer
Medical Insurance Company Name
Your answer
Medical Insurance ID Number
(sometimes this is called the policy number)
Your answer
Other Information
Are you allergic to anything? Do you have any dietary restrictions (not preferences)?
(e.g. food, medications, etc.)
Your answer
Are you currently taking any medications? If so, which ones?
Your answer
Housing and Storage: *
Check all that apply
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.
Required
Notes / Questions?
Your answer
A copy of your responses will be emailed to the address you provided.
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