First Calvary Baptist Church

MLK Registration Form 2020

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Note: Due to the nature of the MLK, Jr Youth Lock-in, it is advised that youth DO NOT transport themselves to and from this event. Youth have the potential to stay awake all night, which may be hazardous for driving. A disclaimer will be provided for signatures during the event's check-in.

All parents or guardians of youth ages 12 - 18 attending the Lock-In must complete and sign the attached contract by December 31,2019. ONLY youth who have met the mentioned deadline will be allowed admittance to the Lock-In with NO EXECPTIONS.

Registration will begin promptly at 6:00pm. There will be NO WALK-INS. All youth participants are to come dressed in age appropriate clothing as outlined below and in the contract.

If you have any questions, before or during the Lock-In please contact Janet Squires, Registration Coordinator at 919-606-4801 or email youthMLKlockin@firstcalvary.org




Section 1-Youth General Information, Artistry Sessions Selections, and T-Shirt Size


First Name Last Name




Select one
Yes
No





Artistry Section descriptions:

Fashion: Looking to design a t-shirt or become a fashion designer? Start with examining the events of life and its impact on the creativity and the world of fashion.

Music: How much does art imitate life? Find out how music writers utilize life and society to get you fascinated with the next big thing!

Visual Arts: Why not decorate your walls as your own artist? Explore your social world and the injustices of the community to show others what you see.

Theater: Is there a better way to express your emotions about what you experience? Yes there is! Theater is life on the stage and big screen. Empower others about the circumstances of society from the stage with your voice.

Poetry/Spoken Word: Is what you say created in just a "snap"? Share your 'tongue of rhyme' and word play to explain how "we shall not be moved!"

Select one topic from each Artistry Session below. Each topic chosen must be different for each session. Duplicate selections will result in a different topic being selected by event coordinators.

If a topic is full, an event coordinator will be in contact to assist with selecting a new topic.

Select one
Fashion (max. 24)
Music (max. 24)
Visual Arts (max. 24)
Theater (max. 24)
Poetry/Spoken Word (max. 24)
Select one
Fashion (max. 24)
Music (max. 24)
Visual Arts (max. 24)
Theater (max. 24)
Poetry/Spoken Word (max. 24)
Select one
Fashion (max. 24)
Music (max. 24)
Visual Arts (max. 24)
Theater (max. 24)
Poetry/Spoken Word (max. 24)
Select one
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult XX-Large
Adult XXX-Large



Section 2-Parent General Information, Emergency/Medical Information

Parent/Legal Guardian Information:


First Name Last Name
Address
Address Line 2
City State Zip Code
Phone Number
Phone Number
Email Address



Emergency Contact Information: (Cannot be Parent or Legal Guardian)


First Name Last Name

Phone Number
Phone Number

*____ This event will be recorded and photographed, please check if you wish for your Youth NOT to be recorded or photographed.




Medical Release Form

In the event of an emergency or illness, Lock-In staff will first call 911 and have your Youth admitted to the nearest hospital. After that call the parent/guardian will be notified.




Medical History

**Lock-In staff will NOT administer ANY medications, therefore if your Youth is on medication notify Lock-In staff upon check-in. The Youth or Guardian will be responsible. I affirm that the above information is true and accurate to the best of my knowledge and hereby release First Calvary Baptist Church and its affiliates from and all liability resulting in injury while participating in the activities.


Section 3-MLK Youth Lock-In Guidelines/Dress Code/Do's & Don't List

Dress Code

In the event that a t-shirt is not supplied youth should wear a solid color t-shirt with no logo. Youth should also bring a coat/jacket to wear to the MARCH. If you plan to play any sports you may bring clothes to change into. Clothing should be comfortable, NOT tight.


Sleep Time

Youth will have an opportunity to sleep. They can bring sleeping bags, and any other item for peaceful rest. Understand youth will be responsible for transporting all items brought with them.


DO'S LIST

Bring POSITIVE and RESPECTFUL attitudes.

OPEN Mind and Energy-Willingness to enjoy and participate in planned activities.

Parents/Guardians MUST check-in all registered youth at MLK Registration tables.

Comfortable clothing (i.e. loose fitting clothes, jeans, sweatpants/shirts,etc).

Comfortable shoes (i.e. sneakers/tennis shoes or shoes with rubber soles only).

Coats, gloves, scarf, and hat-We will be outside for MLK March on Monday morning. Plan accordingly for weather.

Group designated color T-shirts (if provided)-MUST BE WORN AT ALL TIMES.

Sleeping bags/Small blankets/pillows-There will be NO sharing of sleeping materials.

Changing clothes for Recreation Activities (i.e. basketball shorts/t-shirts/sweat towel, etc.)

Personal Toiletries (i.e. toothbrush/toothpaste, wet wipes, sanitizer, deodorant, etc.)

Parents/Guardians-All youth are responsible for all personal items (i.e. bags, clothing, shoes, jewelry, etc.)




DON'T LIST

NO WALK-INS-only Registered school-aged youth 12-18.

NO Drugs, Alcohol, and weapons.

NO Fighting, Disruptive Behavior or use of Profanity.

NO Drop-offs or Leaving Lock-in early. (Special circumstances will need prior approval from Dr. Jacques Wright).

Disciplinary actions and Removal from Lock-in will be taken for any behavioral issues.

NO ELECTRONIC DEVICES (i.e. Cellphones, I-Pads, I-Pods, I-Watch, MP3 players, games, computers, radios, etc.)

Parents/Guardians-We strongly advise that you collect and keep your youth's electronic devices. Otherwise, they will be confiscated at check-in and placed in zip-lock bag until end of lock-in.

Parents/Guardians-In the event, that you need to contact your youth for emergency purposes: Please contact MLK Registration Coordinator, Janet Squires (919-606-4801) or Dr. Jacques Wright (305-502-2445).

NO Clothing revealing any body parts; Ladies and Gentlemen should be fully dressed in appropriate attire.

NO FITTED OR TIGHT ATTIRE (i.e. Leggings, Yoga Pants, etc.)

NO Pajamas or Sleep wear of any style.

NO Open toe shoes, slippers of any style or boots with hard bottom soles.

Select one
Yes
No

Section 4-Signatures/Contract Agreement


First Name Last Name


First Name Last Name

* required