Youth Group Registration Agreement

Please fill in the following information. When we have received your signed agreement and deposit, please allow 2-3 weeks for a confirmation letter. When you receive your confirmation letter, your spaces will be guaranteed. You may add spaces at a later date with an additional agreement form if the additional space is available. Space is reserved on a first-come, first-served basis.

Agreements received after March 31, 2010 will only be accepted with the Total Registration Fee.

Youth Group Name

June

Church/Organization

Please select your session

4-8

Address

8-12

City

State

Zip

14-18

Phone

Cell

Leader Name(s)

Email Address(es)

Please use separate Application Forms for each session you are attending

Conference Registration Fee

Students

x

$250

=

Conference Registration Fees include housing, meals, t-shirt, Bible study materials, speakers, worship leaders, band, D-Group leaders, videographer and recreation.

Adults

x

$250

=

Youth Pastor Kids*

x

$76

=

Total Registration Fee

Deposit (Due with Agreement)

Total Attendees

x

$25

=

Deadline: March 31, 2010

Balance Due

Total Registration Fee

- Deposit

Balance Due

Deadline: May 15, 2010

* Children that have not completed the 5th grade I have read and understand all of the information with this agreement. I acknowledge that Souled Out Conferences recommends that an adult be assigned to each room, cabin or dorm. I acknowledge that Souled Out Conferences recommends at least one female and one male chaperone for a co-ed group.

I have included my non-refundable deposit with this agreement. I acknowlege that my church /organization is now responsible for the full remaining balance listed above for the total number of people registered, regardless of the group's final attendee numbers. I acknowledge the due date for the full balance is April 30, 2010. I understand that my spaces will be guaranteed once I have sent the full deposit and agreement form and receive a confirmation letter.

I hereby release Souled Out Ministries from any responsibility for any injury or death that may occur during or on the way to or from the Souled Out student conference at the beach during the dates indicated above. I understand that I am responsible to oversee, provide and keep my own release forms for each person in my group. I acknowledge that my church/organization is responsible for the well-being of the people that we bring to the conference. I understand that lifeguards will not be provided at the conference, so I will be responsible for my own group’s safety and regulations regarding swim time, etc. I acknowledge that Souled Out suggests that I provide lifeguards and specific swim times and rules for my group. Although the number of chaperones is up to our group, I acknowledge that Souled Out suggests that we provide at least one chaperone for every seven students and at least one chaperone in each small cabin. These adults will be responsible for the well-being of the students while they are at the conference.

Youth Leader's Signature

Date

Pastor or Supervisor's Signature (Required)

Date

Make checks payable to Souled Out Conferences

Mail check with completed application to:

Souled Out Summer 2010 - C/O Jonathan & Lisa Moore

2457 Airport Thruway - PMB #215 - Columbus, GA 31904