2009 Registration

Student Registration Please use blue or black ink & print clearly. Fill in all blanks.

First Name____________________ Last Name ______________________

Male

Female

Address__________________________________ City / State_________________________ Zip___________ Phone (

)________________________ Grade_________ Year of Graduation____________ Age________

Church Youth Director/Pastor

Brenneman Missionary Church / Matt Ransom

I would like to room with (one name only):________________________________________________

Deadline: November 4th

Registration Cost:

$150

Add $10:

$_______

Add $12:

$_______

Epic Bag* (circle size) S M L XL 2XL Add $20 *includes drawstring backpack, above 2 items (DVD and shirt), & much more!

$_______

TOTAL COST:

$_______

Additional Items For Purchase Rewind DVD Only Shirt only (circle size) S

M

L

XL

2XL

or

We (student & parent) have read the 3DYC Guidelines and agree to abide by them. As parent/legal guardian, I also give permission to have video or pictures taken of my student to be used for promotional purposes. I give permission for full participation in all activities unless otherwise indicated. In the event of an emergency, I authorize the 3DYC Director or his representative to grant permission for medical treatment by a qualified nurse, doctor, or hospital for the person registered on this form, to, from and during 3DYC, December 28 - 30, 2009. List any medical problems or medications which should be taken into consideration in the event of an emergency: ________________________________________________________________________________________________________ ____________________________________________________________

Signature required by both student & parent! _______________________________________ Student Signature

______________________________________ Parent Signature (required regardless of student age)

Emergency phone number: (

Date:______________________

)__________________

Sorry, All Money is Non-Refundable!

3 DYC Guidelines

Has God blessed you with a special gift or talent that up until now has been hidden or underappreciated by friends and family? If so, then Epic Spotlight wants YOU! Replacing our traditional talent competition that limited participation to singing, playing an instrumental solo or preaching, and was based purely on quality, Epic Spotlight breaks new ground, expanding to new frontiers of entertainment such as juggling, magic, rhythmic

Remember as you are in the hotel and convention center, that you represent your church and the entire Missionary Church. Therefore, you should always be on your best behavior and obey the rules of each area. 1.

gymnastics, stand-up comedy, chalk art, contortionists, skits, ventriloquism, beauticians, as well as the more traditional talent categories. The possibilities are endless. 2.

ROUND ONE: All entries will be assigned an audition slot during which they will perform before

3.

a panel of qualified judges, who will then determine whether their talent is worthy of a call-back audition. ROUND TWO: Those selected to continue on to the second round will again appear before a panel of judges who will determine if the performance is worthy of sharing the Epic Spotlight with the best of the best.

4.

EPIC SPOTLIGHT: Those selected to perform live onstage in front of 3DYC will compete for

5.

awesome cash and prizes, including $250 cash, iPods, game systems, and much much more! Talent__________________________________ Grade_____

Is this a group entry? Yes/No

If Yes, who are the other members_________________________________________________ 6.

Dodgeball Name:_______________________________ Grade: _________

7.

Max 8 players per team, You are allowed to have two sponsors. 1. 2. 3.

8.

4.

9.

5.

10.

6.

11.

7. 8.

12. 13.

PLEASE NOTE: Everyone who attends 3DYC will have the privilege of playing on a Rally Ball Team!

14.

Any inappropriate behavior will not be tolerated. Those involved will be disciplined, required to call their parents to explain their misbehavior, and/or be sent home at their own expense. If your behavior is unlawful, the local law enforcement agency will be contacted. You are not allowed to write on the hotel windows. Each violation will result in a $10 fine. Modesty is required at all times. Pajamas are not to be worn outside of your room. Remember that other guests are using the hotel. Other people and businesses can see in your window, so be sure to close your curtains when changing clothes, etc. Curtains must remain closed from 9 p.m. to 9 a.m. Intentional immodesty will be dealt with. Walkie talkies, roller blades and skateboards are NOT allowed. You must wear your name tag around your neck at all times. It is your pass to attend the general sessions and participate in all activities. Without it you may not be admitted to meals and activities and may be questioned by security. If you leave it in your room, you will be sent back to get it. If it is lost or damaged, you may purchase a new one in the 3DYC office for $5.00. Your church is responsible for any room damages and will be billed accordingly. If you move something (blanket, pillow, etc.) to another room, you will be charged for it if it is not returned to the original room. Absolutely no guys on girls’ floors and no girls on guys’ floors! No exceptions will be made for devotions, meetings, etc. Any guy caught on a girls’ floor or any girl caught on a guys’ floor will be warned or sent home. Any guy caught in a girls’ room and any girl caught in a guys’ room will be sent home! You may not practice instruments between 9:00 p.m. and 8:00 a.m. Everyone is required to attend all general sessions. You may not leave the hotel/ convention center without being accompanied by your Youth Director or an Adult Leader. The phones in your room are for your c o n ve n ien c e an d n ot y ou r entertainment. Misuse will result in phones being removed from the room. Everyone is to be in their own hotel by 11:45 p.m. and in their own room by 12:00 midnight. The hotels, convention center and 3DYC are not responsible for lost or stolen items. Please keep cell phones from being a distraction during General Sessions.

Sorry, All Money is Non-Refundable!