AMYC 2010

In signing this form and paying the applicable registration fee, I will be deemed to have consented to participation in the 16th Annual Australian Methodist Youth Convention (the “Convention”) held at the Maranatha Recreation and Education Camp in Yandina in the State of Queensland (the “campsite”) organised by the Chinese Methodist Church in Australia, Eight Mile Plains, including the organising committee and other authorised members (the “Church”) at all material times of the Convention and that I will be bound by and agree to comply with the rules, regulations and policies of the Convention and the campsite.

Release and Indemnity: In consideration of the Convention allowing my participation, to the extent permitted by law:
1. Release and will release the Convention, the Church and its agents from all claims that I may have or may have had but for this release arising from or in connection with my participation in or in any part of the Convention and its activities.
2. Indemnify and will keep indemnified the Convention, the Church and its agents in respect of any claim by any person arising as a result of or in connection with my participation in or in any part of the Convention and its activities.

Declare that I have fully disclosed all relevant medical and physical conditions and accept that the Convention will rely upon this declaration as evidence of my health and fitness.

Consent to receiving any medical treatment that the Convention, Church or its agents reasonably consider necessary or desirable for me during my participation. I also agree to indemnify the Convention, Church or its agents of any costs or expenses incurred in providing me with medical treatment.

Acknowledge and consent to photographs and electronic images being taken of me during my participation in the Convention and that such photographs and electronic images may be used without my further consent being necessary.

Understand that the information provided is necessary for the organisation and administration of the Convention and may be disclosed to third parties for the purposes above.

The Convention reserves the right to refuse registration if necessary.

First Name:
Surname:
Gender:	Male Female
Date of Birth:	Note: Under 18s must submit a paper form signed by a parent/guardian
Address:
Suburb:
Postcode:
Home/Mobile Phone:
Email:
Are you a Christian?	Yes No
Name of Church:
Preferred Language (Which part of convention do you want to attend?):	English Chinese
Emergency Contact Details (next of kin):
Name:
Relationship:
Phone No. (Business Hours):
Phone No. (After Hours):
Do you have any medical conditions, allergies or meal requirements?
Flight Details & Transport:
Arrival Date:
Arrival Time:
Arrival Airline/Flight No.:
Departure Date:
Departure Time:
Departure Airline/Flight No.:
Fees (T-Shirt included):
Fee:	Early Bird - ends 31/08/2010 - $160 Normal - closes 31/10/2010 - $180
T-Shirt Size:
Payment Method:	Direct Debit Cheque
1. Direct Debit: Account Name: Chinese Methodist Church in Australia AMYC BSB: 484799 Account Number: 601868900 Please note your name and church as reference.	2. Cheque: To: Chinese Methodist Church in Australia AMYC Address: PO BOX 2362, RUNCORN QLD 4113 Please note your name and church on the back.
Terms of Participation: You must completely read the terms below and check the box.
In signing this form and paying the applicable registration fee, I will be deemed to have consented to participation in the 16th Annual Australian Methodist Youth Convention (the “Convention”) held at the Maranatha Recreation and Education Camp in Yandina in the State of Queensland (the “campsite”) organised by the Chinese Methodist Church in Australia, Eight Mile Plains, including the organising committee and other authorised members (the “Church”) at all material times of the Convention and that I will be bound by and agree to comply with the rules, regulations and policies of the Convention and the campsite. Release and Indemnity: In consideration of the Convention allowing my participation, to the extent permitted by law: Release and will release the Convention, the Church and its agents from all claims that I may have or may have had but for this release arising from or in connection with my participation in or in any part of the Convention and its activities. Indemnify and will keep indemnified the Convention, the Church and its agents in respect of any claim by any person arising as a result of or in connection with my participation in or in any part of the Convention and its activities. Declare that I have fully disclosed all relevant medical and physical conditions and accept that the Convention will rely upon this declaration as evidence of my health and fitness. Consent to receiving any medical treatment that the Convention, Church or its agents reasonably consider necessary or desirable for me during my participation. I also agree to indemnify the Convention, Church or its agents of any costs or expenses incurred in providing me with medical treatment. Acknowledge and consent to photographs and electronic images being taken of me during my participation in the Convention and that such photographs and electronic images may be used without my further consent being necessary. Understand that the information provided is necessary for the organisation and administration of the Convention and may be disclosed to third parties for the purposes above. The Convention reserves the right to refuse registration if necessary. I have read, understood, acknowledge and agree to the above terms including the release and indemnity.
By clicking submit you confirm that you agree to the above terms. Note: You will receive a manual email confirming that your details have been accurately entered into our database. If you do not receive a confirmation email within 7 days, please contact Tim

AMYC 2010

Registration

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