2015 Fine Arts Registration Form Great Falls
April 24-25, 2015 Montana GREAT FALLS Fine Arts Festival Registration Form Location: Great Falls Central Assembly of God Church IMPORTANT INFORMATION: Art/Writing/Video presentations are to be postmarked no later than March 27 Writing categories: submit your presentation(s) through email to Andrew Sheldon: [email protected] Video category: submit your presentation by emailing a youtube link to Andrew Sheldon: [email protected] Art category: submit your presentation to Central Assembly Attn. Andrew Sheldon 2001 Central Avenue Great Falls, MT 59401 1. REGISTRANT INFORMATION Name _______________________________________________________ Grade _______ First Last Birth Date ____/____/______ Gender M F Mailing Address ____________________________________________________________________________________________________ Street or PO Box Phone Number ( ) Apt. City State Zip - ___ I do not give permission for the personal information above to be given to any other AG institution, school, or ministry other than my Network office, NYM and National Fine Arts. 2. CHURCH INFORMATION Name ____________________________________________________________________________________________ Official Church Name Church City State Montana Official Network Name Youth/FA Leader ______________________________________________ E-mail_______________________________ First Last Youth/FA Leader Phone Number ( __ ) __ Leader e-mail REQUIRED for confirmation purposes -_____ 3. MEDICAL RELEASE Registrant’s Full Name (Please print) ______________________________ Parent’s Name (Please print) _______________________________ I assume full liability of hazard and risk for myself (or my child) during the network Festival. I give permission for hospital or medical center staff to administer any necessary treatment immediately to me (or my child) should I (or he/she) be sick or injured during the Festival. I do not hold the network youth ministries nor its respective officers and staff responsible for any injury as a result of my (or my child’s) participation in the Festival. Medications to which the registrant is allergic: ________________________________________________________________________________ Is there anything in the registrant’s medical history staff should be aware of in case of a medical emergency? ______________________________________________________________________________________________________________ Emergency Contact ____________________________________________________________ Emergency Phone ( ) First . Last 4. SIGNATURES REGISTRANT SIGNATURE (required regardless of age)_______________________________________ Date _____/_____/______ Your signature indicates that you have completely read and understand the 2015 Fine Arts Official Rulebook, guidelines, and medical release and will abide by them. PARENT SIGNATURE (required for ALL registrants under 18) _________________________________________________________ Date _____/_____/______ Your signature indicates that you understand and support your child’s involvement in Fine Arts and will abide by all rules, guidelines, and medical release. PASTOR SIGNATURE (required for ALL Fine Arts Participants) _____________________________________ Date _____/_____/______ Your signature indicates approval of this student’s participation in Fine Arts and confirms he/she attends your Assemblies of God church or youth group. 5. COST Cost: $25 for the first category, $5 per each additional category. ALL registration forms MUST be in by March 27 – no exceptions! We are no longer accepting Fine Arts registration forms on-site. Make all checks payable to: Montana Ministry Network Youth Leader, Mail forms to: Montana Ministry Network, Fine Arts 2147 Overland Ave. Suite 100 Billings, MT 59102 406-652-2417 Page 1 of 2 April 25, 2015 Montana GREAT FALLS Fine Arts Festival Registration Form Location: Great Falls Central Assembly of God Church IMPORTANT INFORMATION: Art/Writing/Video presentations are to be postmarked no later than March 27 Writing categories: submit your presentation(s) through email to Andrew Sheldon: [email protected] Video category: submit your presentation by emailing a youtube link to Andrew Sheldon: [email protected] Art category: submit your presentation to Central Assembly Attn. Andrew Sheldon 2001 Central Avenue Great Falls, MT 59401 6. CATEGORIES UNDERLINE all the categories you are registering for. Art Division* Graphic Design Photography, Digital Photography, Film T-shirt Design Visual Art, Three Dimensional Visual Art, Two Dimensional, Alternative Media Visual Art, Two Dimensional, Painting/Drawing Communication Division Children’s Lesson Solo Children’s Lesson Group* Puppetry Solo Puppetry Group* Sign Language Solo Sign Language Group* Short Film * Short Sermon, Jr Short Sermon, Sr Spoken Word Drama Division Drama Solo Drama Ensemble, Large* Drama Ensemble, Small* Human Video Solo Human Video Ensemble, Large* Human Video Ensemble, Small * Instrumental Division Guitar Solo Brass Solo Instrumental Ensemble, Traditional * Instrumental Ensemble, Contemporary Piano Solo Percussion Solo, Traditional Percussion Ensemble, Traditional * Percussion, Unconventional String Solo Woodwind Vocal Division * Christian Band Rap Songwriting, Performance/Worship Songwriting, Modern Hymn Vocal Ensemble, Large * Vocal Ensemble, Small * Vocal Solo, Female, Jr Vocal Solo, Female, Sr Vocal Solo, Male, Jr Vocal Solo, Male, Sr. Worship Team, Sm * Worship Team, Lg * Writing Division * Book Chapter Children’s Literature First Person Essay Flash Fiction Poetry * Art & Writing entries must be submitted to the Central Assembly by March 27, to be judged prior to the FA Festival. They must be picked up at the festival. * Make sure you have the correct GROUP NAME for every group member. * Make sure you have entered the CORRECT CATEGORY for your presentation. The criteria details are in the RULE BOOK. Do not change your entry at the Festival. 6. GROUP LIST To ensure that each individual is placed in the correct group(s), please list the members of your group(s) and accompanists. •Group Name _____________________________________________ Please use a unique name for each group to avoid confusion. Category _____________________________________________________ Accompanist ___________________________________________________ Members ____________________ __________________________ __________________________ __________________________ __________________________ __________________________ •Group Name __________________________ __________________________ __________________________ __________________________ _____________________________________________ Please use a unique name for each group to avoid confusion. Category _____________________________________________________ Accompanist ___________________________________________________ Members ____________________ __________________________ __________________________ __________________________ __________________________ __________________________ •Group Name __________________________ __________________________ __________________________ __________________________ _____________________________________________ Please use a unique name for each group to avoid confusion. Category _____________________________________________________ Accompanist ___________________________________________________ Members ____________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ All group lists must match others in the group. •Group Name _____________________________________________ Please use a unique name for each group to avoid confusion. Category _____________________________________________________ Accompanist ___________________________________________________ Members ____________________ __________________________ __________________________ __________________________ __________________________ __________________________ •Group Name __________________________ __________________________ __________________________ __________________________ _____________________________________________ Please use a unique name for each group to avoid confusion. Category _____________________________________________________ Accompanist ___________________________________________________ Members ____________________ __________________________ __________________________ __________________________ __________________________ __________________________ •Group Name __________________________ __________________________ __________________________ __________________________ _____________________________________________ Please use a unique name for each group to avoid confusion. Category _____________________________________________________ Accompanist ___________________________________________________ Members ____________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ __________________________ Page 2 of 2
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