INVITED! You’re Registration Form Full Name: ____________________________________________________________________ Address: __________________________________City: __________________State: _______ Church: ___________________________ (Circle One) MARRIED SINGLE Emergency Contact: _______________________________ Relationship: ______________ Home #: __________________ Cell #: __________________ Work #: _________________ Email: _________________________________________________________________________ T-Shirt Size: (circle one) SMALL MEDIUM LARGE XL 2XL 3XL I understand that in the event medical intervention is needed, every attempt will be made to contact immediately the person(s) listed on this form. In the event I cannot be reached in an emergency during the activities at YAR 2015 (April 17-19), I hereby give my permission to the physician or dentist selected by the NCDM leadership to hospitalize, to secure medical treatment and/or order an injection, anesthesia or surgery for me as deemed necessary. I understand all reasonable safety precautions will be taken at all times by Discipleship Ministries and its agents during the events and activities. I understand the possibility of unforeseen hazards and the inherent possibility of risk. I agree not to hold Discipleship Ministries, its leaders, employees and volunteer staff liable for damages, losses, diseases or injuries incurred by the subject of this form. Signature: _______________________________________ Mail your registration to : NCDM – PO Box 60-Falcon, NC 28342 ATTN: YAR 2015 Date: _________________ NO Childcare will be provided April 17-19, 2015 FALCON, NC Ages 18 (out of High School) - 30ish Young Adult Retreat YOUNG ADULTS Join us for a weekend of fellowship!! We are Super Excited about our first ever Young Adult Retreat. Make plans now to be a part of this inaugural event. We look forward to seeing you in Falcon April 17th-19th, 2015. Jon Oliver NCDM Director Schedule Friday-April 17th Registration: 6pm-7pm Service: 7:30pm Saturday-April 18th Breakfast: 9am Service: 10:30am Lunch: 12pm Free Time Dinner: 6:30pm Service: 7:30pm Sunday-April 19th Breakfast: 8:30am Devotion: 9:00am Departure: 9:30am Guest Speaker: Dr. Tracy Reynolds, Dean of the School of Christian Ministries, holds a Doctorate degree in Strategic Leadership from Regent University as well as a B.M.Ed. and M.M.Ed. from the University of Georgia. He has taught the gamut of practical Christian ministries courses since coming to EC in 1998. Dr. Reynolds began a career in music as a performer, songwriter, arranger and instructor. He has served as a pastor in local churches for nearly 35 years. Pastor Tracy says, “My passion to train youth workers led me [from being a youth pastor and music teacher] to Emmanuel College…. For the past several years, I have served as dean of the School of Christian Ministries and continue to serve at Grace Fellowship in Athens, Ga. Training next Generational leaders is my life mission. I am more passionate than ever about reaching, teaching, training and unleashing the millennial generation. It is my joy and honor to serve as we grow together to raise up the next generation of leaders for the Kingdom of God.” Music Led By: HOP E TO SEE Y OU T HERE ! Brittanie Taylor is a majorly talented individual who uses her talents to lift up the name above every other name, Jesus Christ! She has been leading worship along the eastern side of the country for more than 10 years and has been involved in music ministry the majority of her life. Brittanie is not afraid to stand and proclaim who she serves and lets her light shine no matter where she is. Her spirit will touch you, her boldness will sometimes shock you, but most of all, her kindness will reach you. $60 Per Person Make Checks payable to NCDM/YAR 2015 FOR QUESTIONS PLEASE EMAIL NOLIVER@NCIPHC.COM
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