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SPUD Overnight
24-25 April 2015
Faith Mission Centre,
Portadown
£25/€25 per person
Nomination deadline:
Friday 17 April
The SPUD Overnight gives
YOU the opportunity to
engage with the mission and
ministry of our church.
SPUD Overnight; Faith Mission Centre, Portadown
Name of delegate ___________________________________________________
Congregation
___________________________________________________
Address
___________________________________________________
____________________________
Telephone no _____________________ Date of Birth ______________________
Email Address
YOU can talk about the issues
that you are passionate about
and SPUD can share them at
the General Assembly in June.
Postcode ___________________________
Dietary Requirements
____________________________________________
_____________________________________________
Medical Conditions
______________________________________________
Delegate signature
_____________________________________________
If you are under 18 years old your parent or guardian will need to complete this part
of your form:
Delegates should be:
 Aged 15-25
 Willing to participate in
discussion
 Willing to listen & respect
the views of others
 Willing to represent their
church at this event
I hereby give permission for my son/daughter to attend the above event and understand
that in the case of an accident or medical assistance that leaders will ensure my child
receives whatever treatment is required and hereby instruct them to act on my behalf in
consenting to such medical assistance.
Signature ___________________________ Date _________________________
(Parent/Guardian)
Emergency contact telephone number:
________________________________
I enclose £/€25 fee, made payable to ‘Presbyterian Church in Ireland’
Please return by Friday 17 April 2015 to:
Do you want to help make the
voice of young people heard
across the denomination?
Speak to your minister, clerk
of session or youth leader to
be nominated
SPUD, CCLW Office, Assembly Buildings, 2-10 Fisherwick Place, Belfast, BT1 6DW
I am happy to endorse the above person as a delegate to the SPUD Youth Assembly from
our congregation
_________________________________ (Signature of Minister or Clerk of Session)