Great Plains

Project Revolution 2018

Project Revolution 2018 - 5 Rivers District Youth Lock-In

For all Youth, 6th through 12th grade

Event Date: September 8-9, 2018

Where: Lawrence 1st West Campus, 867 US - 40 Hwy, Lawrence, KS

Time: 5:00 p.m., Saturday the 8th, to 10:00 a.m., Sunday the 9th (after worship)

Cost: 20.00 if you pay online, or 25.00 at the door

One adult must accompany each group of 1 to 6 youth. All adults helping must be Safe Gatherings Certified.

http;//www.greatplainsumc.org/safegatherings

You can pay online through Paypal or bring your fee that day. You also need to have a medical release on file with your attending youth leader, or bring a completed one that day.

Health Form

***Photos will be taken at Project Revolution that may be used on our website, newsletter or other publications. Registering for this event implies permission for us to use said photos from this event. If you do not want to give permission, it is your responsibility to let us know in writing in advance of this event.

Registration Deadline, August 31st, 2018

 

 

Contact First Name
Contact Last Name
Contact Email
*First Name *Last Name *Email
*Home Address
*City
*State
Phone
*Emergeny Information

Parents or Guardian and Contact Phone Number

Additional Emergency Contact (Can be a Youth Leader) and phone
*Grade

What grade are you in school this fall? Please choose from the dropdown menu.

6th Grade
7th Grade
8th Grade
9th Grade
10th Grade
11th Grade
12th Grade
Adult Youth Leader
Adult Volunteer
*Are you in D.C.Y.M.?
Yes
No
*T-Shirt Size (Adult)

You receive a t-shirt with your paid registration to Project Revolution. Please select the size you need. We will have them available at registration. Please choose from the dropdown menu.

small
medium
large
x-large
xx-large
xxx-large
*Do you have any known allergies?
Yes
No
Please list any diet restrictions in the box below
Registration Fee

Pay with Paypal or if you choose none, mail a check to the district office. Please note that if you pay online, you receive a 5.00 discount. Fee at the door is 25.00.

None
Pay now with Paypal ($20)
Pay at the door ($25)
Pay with a group
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