Montreat Youth Conference Registration Form

"*" indicates required fields

Youth Name*

First Last

Grade Completed as of June 2025*

Gender*

Youth Cell Phone*

Youth Email*

Home Church Name*

Leader's Name*

First Last

Leader's Email*

Leader's Phone #*

Parent or Guardian Name*

First Last

Parent or Guardian Cell Phone*

Parent or Guardian Email*

Mailing Address*

Street Address Address Line 2 City State ZIP Code

Emergency Contact*

First Last

Emergency Contact Cell Phone*

Medical Information

Allergies*

Health History (please include any prescribed medications and instructions in Savannah Presbytery leaders are to administer)*

Month/Year of last tetanus shot*

Insurance Company*

Insurance Member ID

Insurance Group or Policy Number

Insurance Contact Information

First Last

Insurance Policy Holder Name

First Last

Parental Consent and Liability Release

The undersigned does hereby give permission for my youth: (“Participant”), to attend and participate in events sponsored by Savannah Presbytery.

Parent/Guardian please type your youth's name below to indicate your consent.*

First Last

LIABILITY RELEASE: In consideration of Savannah Presbytery allowing the Participant to participate in youth ministry activities, we (I), the undersigned, do hereby release, forever discharge and agree to hold harmless Savannah Presbytery, its directors, employees, volunteers and agents (collectively herein the “Church”) from any and all liability, claims or demands, for accidental personal injury, sickness or death, as well as property damage and expenses, of any nature whatsoever which may be incurred by the undersigned and the Participant while involved in the youth activities. We (I) the parent(s) or legal guardian(s) of the Participant hereby grant our (my) permission for the Participant to participate fully in youth ministry activities, including trips away from the church premises. Furthermore, we (I) [and on behalf of our (my) minor Participant(s)] hereby assume all risk of accidental personal injury, sickness, death, damage and expense as a result of participation in recreation and work activities involved therein. Further, authorization and permission are hereby given to said Church to furnish any necessary transportation, food and lodging for this Participant. The undersigned further hereby agree to hold harmless and indemnify said Church for any liability sustained by said Church as the result of the negligent, willful or intentional acts of said Participant, including expenses incurred.