Youth Forum 2025

Name*

First Name Last Name

Email*

Gender*

Age*

Grade*

Baptized?

Yes
No

Address Line 1*

Address Line 2

City*

State / Province*

Zip Code*

Teen's Cell Phone Number

Teen's Email Address

Volunteer Options

Willing to lead singing
Willing to lead prayer in worship service
Willing to help with collection
Willing to give the focus for the Lord's Supper

Housing Arrangements

I will need housing for the following nights:*

Friday
Saturday
I do not need housing

I have already made arrangements to stay with

If it is possible I would like to stay in the home of

Roommate request

Estimated Arrival Time

Parent/Guardian Info

First Name*

Last Name*

Parent/Guardian Phone*

Parent/Guardian Email*

Waivers

Permission to Leave

Parents, please be advised, that without expressed and written permission, your child will not be allowed to leave the event. This includes the Saturday outing venue, in which teens will be transported by bus. Other than Youth Retreat activities, please disclose any plans for your child to leave the retreat venues, and with whom, during the weekend. This authorization absolves us of responsibility while your teen is away from the retreat.

Shirt Size*

Small
Medium
Large
X-Large
XX-Large
XXX-Large

Medical Consent

Date of last tetanus shot

Insurance Company

Group Number

Insurance group identifier

Policy Number

Insurance policy

Health Concerns

Please specify any health concerns that might require attention or medicines that must be taken during the forum. Also, please use this space to notify us of any food or drug allergies.

Allergies

Medical Consent*

In the event of an emergency or non-emergency situation requiring medical treatment, I hereby grant permission for any and all medical and/or dental attention to be administered to my child, in the event of an accidental injury or illness, until such time as I can be contacted. This permission includes, but is not limited to, the administration of first aid, the use of an ambulance, and the administration of anesthesia and/or surgery, under the recommendation of qualified medical personnel.

I have read and agree to the medical consent detailed above.

Emergency Contact

First Name*

Last Name*

Phone*

Terms & Conditions*

By virtue of completing and submitting this registration form, you are acknowledging that you are the parent or legal guardian of the student being registered. Furthermore, you covenant and agree that the Anchorage Church of Christ, 2700 DeBarr Road, Anchorage, Alaska, will not be responsible for any accidents in which my said child may become involved at the Youth Forum, or in going to or returning therefrom. You hereby assume all responsibility for such accidents and any and all medical attention that may be necessary as a result thereof. You also acknowledge that you have read the rules and behavior expectations and have discussed them with the registered student. You further certify that the registered student has read the rules and behavior expectations and understands and agrees that they are reasonable and necessary for the success of the Youth Forum and agrees to abide by these rules and behavior expectations.

I have read and agree to the terms and conditions detailed above.

Ticket	Price	Quantity
Youth Forum 2025	$20.00	Sold out
Total	$

2700 DeBarr Road Anchorage, AK 99508

Event Details

Alaska Youth Forum Registration - Sign up today!