Registration:

Name: ___________________________Age: _____________

__ male __ female School: ______________________

Grade ____

Parent/Guardian’s Name:
_____________________________________________

Address:
_______________________________________________________

City:_______________________ Zip Code: __________

Phone: ____________________ Alt: phone: _________________
Student’s email: ____________________
Yakima Sundome Parent’s email: _____________________
Staying at Yakima Central Assembly of God
I, _________________ and have explained to my child that his/her
Worship by Canvas attendance at this youth conference is a privilege, not a right, and is
conditioned on his/her acceptable behavior. I realize that youth con-
ference is something that will substantially benefit my child, and be-
havior that contravenes the following guidelines may result in his/her
Bring a Friend who dismissal from conference, at the parents’ expense. In consideration
doesn’t know Jesus, of the benefits of this conference to my child and other good and
valuabe consideration, receipt of which is hereby acknowledged, we
and they go free! agree to the following:
Speakers:
1. students will abide by all conference and facility regulations
2. students are not allowed to leave the conference or facilities
without permission, or youth sponsor.
Jeremy Johnson Jeffrey Portmann Vic Murphy 3. students are required to attend all services
4. students will wear modest clothing at all times

I have read and understand the guidelines and conditions for my at-
tendance at youth conference and will abide by them under the direc-
tion of the conference and our church’s youth staff.

Dated this: ________ day of ________________2008

Student’s Signature: _____________________________________

Cost:  $75.00 Parent’s Signature: ______________________________________