Please give information on each teen who will be attending
RPG Registration Form
(*Required)
Please also complete the other side
*Last Name*First NameGrade (Fall 2015) Gender Age
#1
#2
#3
#4
*Address
*City
*State
*Zip
*Phone (
)Email
Your Church
Tshirt
This year RPG will begin a day before the adult conference, on Tuesday, July 14th. Check-in will be at
Grace Bible College from 7-8pm on July 14th. Later check-in will be available at 6:00pm Wedesday, July 15th
at Rush Creek Bible Church for students who are unable to join us until the beginning of the adult conference.
Payment Information
# of
students
Youth Track - “RPG” (7th - 12th grade)
Select all choices that apply
Youth Track - per student (Tue-Sat) please mark in box by name$65.00 x
Youth Track - per student (Wed-Sat)$55.00 x
Late registrations received after May 30
deadline add $5.00 per student
Line
Total
= $
= $
= $
Late Fee: $5.00 x
Total payment this page: $
Send this form with check or MO to: Grace Gospel Fellowship, PO Box 9432, Grand Rapids, MI 49509
Online Registration also available: www.ggfusa.org/RPG2015
(Online registration - you may pay with a check or credit card)
By signing this form I am giving my son/daughter permission to attend the 2015 Grace Gospel Fellowship RPG Youth Conference.
I am also giving Terrah Quesada or other on-site adult leader (on behalf of the GGF) permission to seek medical treatment
should it become necessary.
*STUDENT CONDUCT COVENANT
In signing below, I acknowledge that I will refrain from bringing the following items to RPG.
Guns, knives, or weapons of any kind; fireworks, lighters or matches; illegal, non-prescription drugs, offensive and/or inappropriate
reading materials of any kind; mp3 players or any other electronic listening device, electronic gaming devices or cell phones.
Students are expected to participate in activities and discussion times. Student conduct is expected to be positive, unifying and
non-divisive.
Activities and games will require varying degrees of physical involvement. Clothing and attire will be modest and appropriate at all
times. Students will not leave the activity grounds, or place themselves in any situation without an adult chaperone representative
of RPG at any time. Possession of an item considered contraband is viewed as a violation of this code of conduct. Violation of this
code of conduct will result in one or all of the following disciplinary actions:
1. Confiscation of said item for return to student’s parent upon return home.
2. Warning to student.
3. Parental contact and involvement.
4. Dismissal from the remainder of conference (parents must come and pick up their student).
In the event I violate this covenant, I acknowledge that my participation at RPG can be terminated at the discretion of the leadership of
RPG. I acknowledge that I may be requested to return home before the completion of the conference, with no further participation in
activities or events sponsored by the GGF.
*Student Signature
I acknowledge my responsibility to transport my son/daughter from the activities of RPG to home in the event a violation of this code
of conduct covenant occurs, and it is deemed necessary that my child should not continue as a part of RPG.
*Parent/Guardian Signature
I give my permission to use photos of my child for GGF promotional purposes. Signature
Please email me photos of my child before use. Email:
Date