Confirmation - 2019
Begins Feb 17 | 10:00 - 11:15 am

COST: $60 per student. (includes retreat)

STEP 1: Please complete one registration form per student.

YOUTH INFO
* full name used on certificate
**used for communication and confirmation emails - check for typos**


ADDRESS


PARENT/GUARDIAN INFO
**used for communication and confirmation emails - check for typos**


YOUTH MEDICAL INFO

leave blank if none.


IMPORTANT INFO
leave blank if none.
REFLECTION QUESTIONS


*PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



*RELEASE

Submitting this on-line form will be the equivalent of signing a paper registration form.

  • I have read and understand the above information. The information I have given EPIC is accurate and true to the best of my knowledge.
  • My electronic signature signifies my understanding that submitting this online form will be the equivalent of signing a paper registration form.

 

Due upon registration.


When this form is processed, you will receive a confirmation email with payment instructions. Thank you!