Winter Jam 2019
Who: All Middle and High School Students
Cost: $50 (Includes t-shirt, early access for good seats, Q&A with Artists before concert, discounted merchandise, WJ collectable lanyard, and more!)
*($45/student if registered by January 4th)
What: Winter Jam Concert
Where: Schottenstein Center, Columbus
When: Saturday, January 19th
*Will leave from the Youth House at 4:00pm. Leaders will drop student off at their homes between 11pm and Midnight. Contact Val Rogers for questions (614-352-8365)
Why: Because Winter Jam is AWESOME!

Payment Due By: January 17th
*Make checks out to Faith Covenant Church, Memo: Winter Jam

STUDENT INFORMATION
Student First Name *
Your answer
Student Last Name *
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Birthday *
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Grade *
T-Shirt Size *
Student Cell Phone
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PARENT/GUARDIAN INFORMATION
Parent/Guardian Name(s) *
Your answer
Parent/Guardian call numbers(s) *
Your answer
EMERGENCY CONTACT INFORMATION
Emergency Contact Name *
Your answer
Emergency Contact phone number (S) *
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ADDITIONAL INFORMATION
Please list any allergies, medications, event specifics, etc.
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CONSENT
Parental/Guardian "General Consent": "By submitting this registration form I agree that my student will be at the specified youth event for the designated times, under the supervision of the event leaders."
Please check the boxes below for which you give your consent: *
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