The Depths Calgary 2024 Registration

Depths Calgary 2024 Registration

"*" indicates required fields

Step 1 of 4

25%

Participant Name*

First Last

Gender*

Female

Male

Birth Date*

What year will you graduate from high school?*

Your Home Parish (Name, City)*

Participant Cell Phone (ONLY if you have one. Do NOT put your parent's as we will ask for theirs later.)

Participant Email (ONLY if different from your parent's. We will ask for theirs later.)

Enter Email Confirm Email

Parent / Guardian Name*

First Last

Parent / Guardian Phone (Cell is Preferred)*

Parent / Guardian Email*

Enter Email Confirm Email

Address*

Street Address City Province Postal Code

Medical Information

Health Number*

Allergies (non-food related)*

Have you been diagnosed with a dietary restriction by a physician?*

Yes

What diagnoses have you received? (Check all that apply)*

Celiac

Nut

Dairy

Other

Please specify:*

Do you have a dietary sensitivity?*

Yes

Are you lactose intolerant?*

Mildly

Moderately

Severely

Do you have a gluten sensitivity?*

Mildly

Moderately

Severely

Are you a vegetarian?*

Yes

Any other dietary restrictions?*

Yes

Please list them, and how severe they are.*

Illnesses or Medical Conditions (Please state everything. This information is very important, especially in medical response situations.)

Are you currently taking any medication? (Even if taken occasionally)*

Yes

Please list your medications and how often you take them*

Have you been hospitalized for any reason in the last two years?*

Yes

Please explain why you were hospitalized*

Family Doctor & Phone Number*

Emergency Non-Parent Alternative Contact Name*

Phone Number*

Relation to Participant*

Depths Agreement

I will uphold all participant expectations, and understand that I am responsible for my own actions.*

I agree

I agree that $25 of the registration fee is non-refundable if I am no longer able to attend. (Exceptions may be made under unique circumstances.)*

I agree

I allow FacetoFace to notify me monthly about upcoming events and news.

I agree

Liability Release (to be filled out by a parent unless registrant is 18 years old)

The following liability release waiver is for all the FacetoFace Events I, and/or my child, may participate in during 2024, including the FacetoFace Road Trip, FacetoFace E3 events, FacetoFace Depths Retreats, FacetoFace Ignite Camps, FacetoFace United Conference, and any other events.

I hereby acknowledge that sufficient information has been, and will be, provided by the event coordinators with respect to the planned activities, durations, locations, methods of transportation, sleeping arrangements, participants, and supervision.*

I agree.

I do hereby release and forever discharge FacetoFace Ministries from all manners of actions, claims, and demands of every kind, which I shall or may have for any reason arising from any FacetoFace Events in 2024*

I agree.

I assume all risks and hazards incidental to or attendant with me and/or my childs participation in any FacetoFace Event in 2024, and in each phase of it.*

I agree.

I take responsibility for arranging transportation to and from the events. I understand that parents/guardians of all children and youth are responsible for transportation to and from the events. Youth with licenses will drive themselves/others only with my permission.*

I agree.

In the event that I am unavailable (parents/gaurdians), or unresponsive (adult participants), I do hereby give consent for all emergency medical care (including surgery, if deemed necessary and recommended by at least two attending physicians) prescribed by a duly licensed physician for my child/me in the event of injury or illness during the FacetoFace Events in 2024. This emergency medical care may be given under whatever conditions are deemed necessary, so as to preserve and protect life, limb, health and well-being of me/my child.*

I agree.

I understand that photos and/or video may be taken of me or my child for use in promotional material and I waive the right to inspect or approve them if used for such purposes.*

I agree.

I understand there is a certain non-refundable amount of for each event if I am no longer able to attend. (Exceptions may be made under unique circumstances.)*

I agree.

I have carefully read these statements, and my signature below acknowledges that I fully understand the consent and meaning of these statements.*

I agree.

Parent Signature (or Registrant who is 18 years or older)*

Printed Name*

Date*

By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.*

I agree

Payment

Depths Calgary 2024 - Late Payment

Price:

Select your method of payment*

Credit Card

Cheque

Credit Card*

MasterCard

Visa

Supported Credit Cards: MasterCard, Visa

Card Number

Expiration Date Month Year

Security Code Cardholder Name

Please mail the cheque to: FacetoFace Ministries 3318 Millar Ave, Saskatoon, SK, S7K 7G9*

I agree

Name

This field is for validation purposes and should be left unchanged.