ASPIRE2018 Use this sheet as a guide to help gather the necessary information for online registration.
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- Douglas Lyons
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1 For Pastors For Pastors/Leaders: This form should accompany all registration forms for the event which you are registering. Make more copies of this form as needed. Please be sure to place this on the top of your registrations (online confirmation) and bring with you to pick up registrations on-site. Be sure to list all persons (adults and youth) registering on this form. Please include the complete medical release forms and participant covenants for youth. You should make two copies of this packet. One will be given to the District staff and the other to remain with the youth leader/pastor. Note: Include the name of pastor on the chart to receive a t-shirt. STEP 1. CHURCH INFORMATION Church Name: Address: City: State: Zip: PASTOR/YOUTH LEADER INFORMATION Pastor: Phone (h): Phone (m): Youth Leader: Phone (h): Phone (m): Youth Leader: Phone (h): Phone (m): PRESIDING ELDER DISTRICT (CHECK ONE) Columbia Annual Conference Columbia District Lancaster District Newberry District Palmetto Annual Conference Mt. Pleasant District Kingstree District Georgetown District Central Annual Conference Orangeburg District Manning District Wateree District Piedmont Annual Conference Greenville District Abbeville-Greenwood District Northeast Annual Conference Sumter District Florence-Dillon District Marion District South Carolina Annual Conference Edisto District Charleston District Beaufort District Early Registration: $55 Adults $45 Youth/Young Adults on or before June 27th Regular Registration: $65 Adults $55 Youth/Young Adults after June 27th STEP 2. REGISTRANT S INFORMATION For additional registrants, see page 5. Name of Registrant Registration Tpe Adult or Youth T-Shirt Size Health Form (Y or N) Chaperone (Y or N) Registration Cost
2 CALCULATE REGISTRATION TOTAL Adults Youth & Young Adults Number of Participants: X $ (Fee) = $ Number of Participants: X $ (Fee) = $ Adult Total: $ + Youth Total: $ = $ total registration contribution CHAPERONES AND T-SHIRTS Total # of Chaperones: (must have 1 per 8 youth) # of T-Shirts: (Please total shirts for Youth & Adults) Youth Small Youth Medium Youth Large Adult Small Adult Medium Adult Large Adult X-Large Adult 2X-Large Adult 3X-Large Adult 4X-Large STEP 3. CHOOSE APPROPRIATE TRACKS STUDENTS Exploring God s Masterpieces (Wheatley and Hughes) - Faith-filled and fun track for students in grades K-5. Track includes programming for students starting on Wednesday at 9am and lunch on Thursday and Friday. Ready, Set, Go! (Wright and Giovanni) - Faith-filled and fun track for students in grades 6-8. Track includes programming for students starting on Wednesday at 9am and lunch on Thursday. Dream BIG! (Angelou and Baldwin) - Faith-filled and fun track for students in grades Track includes programming for students starting on Wednesday at 9am and lunch on Thursday. EMERGING YOUNG ADULTS (AGES 18-26) Emerging Vision - Developing a sense of purpose, identity, and motivation are steps on the path to becoming an emerging adult. Track designed for young adults seeking to find God and direction on next steps.
3 ADULT LEARNING TRACKS (NON CERTIFICATION) ---- Choose one Faithful and Chosen Women of God - Track designed to encourage and empower the spiritual lives of Christian women. Purchase the companion study resource ( Successful Women of the Bible ) for this track in the Optional section at the end of registration. Quiet Strength: Men who WIN - Track designed to build the character and spiritual lives of Christian men. Purchase the companion study resource ( Quiet Strength: Bible Study for Men ) for this track in the Optional section at the end of registration. Courageous Clergy Leadership - Clergy Track for ordained ministers in pastoral and specialized ministries. Curriculum to include tools for relevant and practical ministry in today s context. Areas of focus: narrative preaching, church administration, courageous leadership. Institute for New Clergy - Register for this track to learn how to become innovative, prepared, and disciplined clergy in the AME Church. This track is designed for all students in the Board of Examiners. This track requires an additional fee for materials and a certificate upon completion. This Far by Faith: Power of Song - Track designed for participants interested in the music and Christian arts ministries. Classes will also be offered to train Music Directors and Musicians on planning, leadership and faith building through music. Youth Ministry Leadership: Foundations - Register for this track to learn how to build relationships with youth, develop a youthcentered theology and foundations for a youth ministry. Classes offered will satisfy requirements in the Youth Ministry Leader Certification, Sunday Church School Superintendent Certification, and Bible Study Teacher Certification program. Participants seeking certification should choose the Certification option which requires an additional fee for materials and certificate that will be presented upon completion. Nehemiah Academy for Entrepreneurs, Small Businesses, and Nonprofits - Track designed for Christian creatives who are interested in design, marketing, graphics, photography, social media. Let Justice Roll! - Track designed for those working in the areas of social justice, law enforcement, law reform, public policy, and community involvement. Biblical Engagement and Study - Track designed for those seeking to learn more about the Bible, stories of the unknown and how to engage African-American Biblical Interpretation. Classes included in this track are requirements for Christian Education Director Certification, Sunday Church School Superintendent Certification, and Bible Study Teacher Certification. Tribe for Christian Writers - Track designed to equip faith writers on how to cultivate ideas and communicate them in creative ways. LEARNING TRACKS (CERTIFICATION) Each certification track requires core and elective courses for completion. Different classes will be offered at every Episcopal District meeting and the Christian Education Leadership Development Weekend in January Christian Education Director (new) - The newly designed Christian Education Certification Director track for persons seeking to be equipped with the skills to lead and strengthen the ministries of the church. Some of the courses offered during the CEC will satisfy requirements for the path to certification. Cost $50, Credits 2 Sunday Church School Superintendent (new) - The newly designed Sunday Church School Superintendent track for persons seeking to be equipped with the skills to lead and strengthen the Sunday Church School Department. Some of the courses offered during the CEC will satisfy requirements for the path to certification. Cost $50, Credits 2 Sunday Church School and Bible Study Teacher (new) - The newly designed Sunday Church School Teacher track for persons seeking to develop skills, knowledge, and behaviors to be certified as a Sunday Church School or Bible Study Teacher. All teachers should be certified every two years to remain active and fresh in practice. Some of the courses offered during the CEC will satisfy requirements for the path to certification. Cost $35, Credits 1 Youth Ministry Leader (new) - The newly designed Youth Ministry Leader Certification track for persons who desire to lead youth ministries on any level of the church. This certification is open to all AME members who work with youth and children. Cost $25, Credits 1
4 STEP 4. ADDITIONAL INFORMATION Make all payments online via the 7h Episcopal District Registration Website. All participants must be registered online to be processed and receive conference materials. It is strongly recommended that one representative from the church submit all information for each attendee. PLEASE CHOOSE PAYMENT METHOD CREDIT CARD CHECK/ACH CHECK NUMBER REGISTER BY GROUP ONLINE 1. Complete the online registration at 2. Instructions on how to create a group using the Pastor s Registration: 3. Go to registration page 4. Select <Already Registered> link 5. Enter Primary Registrant s (Pastor s) address and confirmation number (The primary registrant will have access to all group members information and the ability to add additional registrants. Pastors have been designated as Group Leader, unless an Administrator was initially selected at the beginning of a registration) 6. Select <Register> button 7. Enter Registrant s Information 8. After entering Registrant s information, there will be an option to continue adding another Registrant by selecting the <Add Person> button or finish registration process by selecting the <Finished Adding People> button 9. Complete registration by making payment 10. After registration is complete an will be sent to the primary registrant with confirmation information. YOUTH FORMS 1. Complete the Youth Participant Covenant, Permission Slip and Medical Release for each youth
5 Early Registration: $55 Adults $45 Youth/Young Adults on or before June 27th Regular Registration: $65 Adults $55 Youth/Young Adults after June 27th ADDITIONAL SPACE FOR GROUP REGISTRATION Name of Registrant Registration Tpe Adult or Youth T-Shirt Size Health Form (Y or N) Chaperone (Y or N) Registration Cost
6 God First Christian Education Leadership and Youth Congress Participant Covenant To be completed by all participants 18 and under. Believing that I am a part of the faithful community of the whole people of God at the event, I promise to be responsible for my actions, abide by the Seventh Episcopal District guidelines and be open in mind and heart to the teachings and leading of the Holy Spirit. I promise to do my part to make the experience of all other participants and/or leaders one that is safe, enjoyable and free from unkindness and insensitivity. As a conference participant, I promise to participate in the building and caring for a faithful community by: Dressing appropriately by not wearing clothing that is too revealing: i.e. short shorts, bikinis, strapless tops or dresses, shirts that allow for a bare midriff, pants worn below the waistline. I will not bring t-shirts that advertise alcohol or tobacco or other illegal substances; nor which contain language/pictures that demean or ridicule someone s gender, sexuality or ethnic origin. Refrain from the use of tobacco products, alcohol and illegal drugs during this event and while traveling to or from this event. Refrain from inappropriate sexual behavior during this event. Leaving at home items such as: skateboards, scooters, rollerblades, firearms, knives, weapons of any kind, incendiary devices (matches, lighters, fireworks and so on), laser pointers, or other items that could disrupt the conference or other Florence Civic Center and/or hotel guests. Participate in all scheduled activities and honor all meeting times. Abide by all quiet-times, or curfews scheduled or announced. Swimming in groups, at all times with an adult leader over the age of 21 always. Respect the personal belongings and residential spaces of others by not entering any hotel rooms or buildings that are not my own. Do no intentional or careless harm to the personal belongings of others or to the buildings, grounds, equipment or other resources of the Florence Civic Center and the hotel where I will be lodged. Respect the role of responsible adult leaders from my church, other adults and the event leaders by maintaining and constant communication with my church group leaders(s) so that my whereabouts and personal safety are not of concern. Constantly seek to be a faithful and responsible example for the group at this event. I understand: In a community based on love, respect, trust and support, each participant is responsible for his or her own actions. I also understand that if I fail to live up the expectations of this covenant, I may be sent home at the discretion of the event director and at the expense of the participant or his or her parents. PARTICIPANT S NAME: SIGNATURE: DATE: PARENT/GUARDIAN S NAME: SIGNATURE: DATE: PASTOR S NAME: SIGNATURE: DATE:
7 God First Christian Education Leadership and Youth Congress Parental/Guardian Consent, Liability Waiver and Medical Consent Form GENERAL INFORMATION Participant s Name: Date of Birth: Home Address: City: State: Zip: Parent(s)/Guardian(s): Phone (h): Phone (w): Phone (m): Grade: Age: Sex: PARENT CONSENT & LIABILITY WAIVER Important! To be filled out by the Parent/Guardian for youth under 18 years of age. If participant is 18 years of age or older, consent must be signed by the individual. I (name of parent/guardian) grant permission for my child, (participant s name), to participate in the Christian Education Leadership Congress, August 1-4, at the TD Convention Center, Greenville, South Carolina. I agree on behalf of myself (name of parent),, my child named herein, or our heirs, successors, and assigns and defend the Seventh Episcopal District, the sponsoring church (its pastor, youth ministry leader, other agents, etc.) or any representatives associated with the scheduled activities. In signing this form I certify that all information contained herein is true and accurate to the best of my knowledge. Signature (Parent/Guardian) YOUTH PARTICIPANT In signing the line below I agree to abide by any/all policies and rules established for this conference. Should I not be able to maintain the guidelines and expectations of the adults and my peers, I understand that that based on the circumstances I may be removed from the activity and be sent home. Signature (Youth Participant) PHOTOGRAPHY CONSENT As parent/guardian, I understand that promotional pictures (individual and group) may be taken during this event, I give permission for my son s/ daughter s picture to be used for promotional materials (newsletter, web page, calendars, powerpoint, etc.) in highlighting the event. Signature (Parent/Guardian)
8 God First Christian Education Leadership and Youth Congress Parental/Guardian Consent, Liability Waiver and Medical Consent Form MEDICAL CONSENT Medical Matters I hereby warrant to the best of my knowledge, my child is in good health, and I assume all responsibility for the health of my child. Of the following statements pertaining to medical matters, sign only those in accordance with your wishes: Emergency Medical Treatment In the event of an emergency, I hereby give permission to transport my child to a hospital for emergency medical or surgical treatment. I wish to be advised prior to any further treatment by the hospital or doctor. In the event of an emergency and you are unable to reach me, contact: Name & Relationship Phone Family Doctor Medications My child will bring all such medications, well labeled, in its original container, that are necessary. Names of medications and concise directions for seeing that the child takes such medications, including dosage and frequency are, as follows: My child is taking the following medication at the present time. Medications My Son/Daughter: Has had an episode where the following has occurred or has been diagnosed: Seizures Asthma Diabetic Allergic reactions to the following (foods, dyes, latex, etc.) Has had a medical surgery within the last six (6) months? Yes No Still under doctor s care? Yes No Has a medically prescribed diet? Has the following physical limitations Immunizations current and up-to-date: Yes No Date of last tetanus/diphtheria immunization You should also be aware of these special medical conditions of my child: No, I do not carry medical insurance at this time. Phone Dosage Administer: I hereby Do Not Grant Permission for medication of any type, whether prescription or nonprescription may be administered by my child unless the situation is life threatening and emergency treatment is required. (Please initial) I hereby Grant Permission for nonprescription medication (such as Tylenol, throat lozenges, cough syrup) to be given to my child, if deemed advisable. (Please initial) MEDICAL CONDITIONS (Seventh Episcopal District will take reasonable care to see that the following information will be held in confidence.) INSURANCE INFORMATION Insurance Carrier: Name of Insured: Policy No: Father s Name: Home or Cell Number: Mother s Name: Home or Cell Number: Signature (Parent/Guardian) Parent/Guardian must sign for anyone under 18 years of age Signature (Participant) Participant 18 years of age or older must sign own consent
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