G.A.M.E.

Registration
June 8-12, 2011

Name: __________________________________________________________________

Address: __________________________________________________________________

City, St, Zip: __________________________________________________________________

Student Date of Birth: ___________________ Current Grade Level: _____________________

Student Cell Phone: _____________________ Parent Phone: ___________________________

Student Email: __________________________________________________________________

Amount Paid: $___________ Church Group: __________________________________________

Total cost for Student participants and Youth ministers is $60.00 and includes meals, lodging, and t-shirt. Other
adult volunteers are free, unless they want a t-shirt, they must pay a cost of $10.00. The full balance will be due
by May 1, 2011. Make checks payable to G.A.M.E.

T-Shirt Size: XXL_____ XL_____ L_____ M_____ S______

Code of Conduct
During G.A.M.E. (God’s Aid and Mission Experience), it is imperative that parents and students understand
that we represent Jesus Christ and the Church. Our behavior should be exemplary both individually and as a
group. We have set high standards and expectations with respect to conduct. Should it be necessary to send a
student home, the student will call the parents, and the parents agree to leave immediately to come to the retreat
center to pick them up. I understand this code of conduct policy and agree to pick up my student if requested.

For the safety of all involved, we mustn’t allow students to leave the retreat at any time. Students will check
in Wednesday evening and stay at the retreat location until Sunday morning. I understand that my student will
stay at the retreat location for the duration of the G.A.M.E. event.

I also grant permission for pictures of my student or myself participating in the G.A.M.E. event to be taken and
possibly posted on one of our church websites, the G.A.M.E. website, or future G.A.M.E. advertisements.

____________________________________ _______________________________________
Student Signature Parent Signature