Registration Form - The Reformed Presbyterian Church

Conference Rates and Registration Form
Room
Full-Time
Administrative Details
REGISTRATION FEES ARE DUE BY JULY 3, 2015
Daily *
Adults/College
$210
$50
Youth (Age 12-HS)
$180
$45
Juniors (Ages 6-11)
$130
$40
Pre-School (Ages 3-5)
$70
$30
Nursery (0-2)
Free
Free
Registration Fee (per person)
$15
$15
Scholarships: Some congregations offer financial aid to
members. If cost is an obstacle, please speak with an Elder.
Bring your own:
Bible, Psalter, notebook, pens
Talent show props and equipment
Towels, sheets, blankets, pillows, toothbrush, toiletries
Check-in: Will be from 2-5pm, July 25th (Saturday). Dinner
will be provided from 5:00-5:45pm EST.
* Daily Rate includes 3 meals and 1 night’s lodging.
Unaccompanied attendance: Some youths may be permitted to attend without their parents; however, arrangements must
be made and approval given in advance. Attendance will require responsible adult supervision. If you are considering this,
please e-mail:
IMPORTANT: $25 late registration fee per person after July 3rd
Name:
Address:
[email protected]
City/State/ZIP:
Phone:
Congregation:
Names (& ages for High School and younger as of 8/31/15)
Name (More spaces on back of form) Gender
Age
1.
2.
3.
Detach along perforated line
Email:
Room Assignments: Will be based upon the following criteria (knowing your concerns early is helpful and appreciated):
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



Size and needs of family
Handicap or disability
Full-timers have higher priority
Early registration
Special requests
High School attendees will be housed with their gender groups
unless otherwise notified. Jr. High attendees will stay with their
families.
Facilities & Area Attractions: Campbellsville has family
4.
5.
6.
Full-Time Room/Board
#
$
Adults/College
$210
Youth (Age 12-HS)
$180
Juniors (Ages 6-11)
$130
Pre-School (Ages 3-5)
$70
Nursery (0-2)
Free
Total Full-Time (add $25pp, if late)
Total Amount Due
Amount Enclosed
Balance Due
$15
Amount
friendly air-conditioned dormitories, cafeteria, comfortable meeting rooms and indoor recreational facilities, including a pool. The
campus is ideally located amid the peaceful Kentucky countryside, close to Louisville, Lexington, and Nashville. Beautiful
Green River Lake, a 10,000-acre recreational state park, is just
five miles from campus.
Questions: Visit www.RPCNA.org/conferences where you will
find a electronic version of this form.
E-mail any questions to:
[email protected]
Print out the form and send it in. You may mail the Registration
Fees only or pre-pay the entire amount. Make checks payable
to COVFAMIKOI Family Conference and send to:
Shane and Lisa Shoop
2595 Franklin Street
Columbus, Indiana 47201
NOTE: Late Fees ($25/person) apply if mailed after July 3, 2015
Great Lakes-Gulf Presbytery presents ...
COVFAMIKOI
2015 FAMILY
CONFERENCE
July 25 — July 30
Campbellsville University, KY
Conference Psalm: 116D
CONFERENCE SPEAKERS
YOUTH MEDICAL RELEASE FORM
Adult Program: Matthew Kingswood
Russell RPC, Ottawa, Ontario
I give my permission for:
________________________________________________
________________________________________________
________________________________________________
Matthew Kingswood is the pastor of the
Russell RPC, near Ottawa, Ontario. Matt’s
parents exposed him to a living, biblically
grounded faith in Christ, and by God’s
grace knew Jesus as savior from early
days. After studying at Carleton
University, he received his theological
and pastoral training at Ottawa
Theological Hall and Knox Theological
Seminary in Ft. Lauderdale, Florida. Matt and Tara have 6
children - Elia, Abigail, Graeme, Emily, Katie and Esther.
Son/Daughter Name(s)
To attend and fully participate in the 2015 COVFAMIKOI
FAMILY CONFERENCE July 25-July 30, 2015 at Campbellsville University including participation in both campus and off-campus activities. If my son/daughter is
injured and I cannot be reached, I give my permission
for medical treatment to be administered as necessary.
Detach along perforated line
High School Program: Rutledge Etheridge
Geneva College, Pennsylvania
Rutledge Etheridge currently serves as
Chaplain for Geneva College and also teaches
part-time in the Department of Bible, Christian
Ministries and Philosophy. He has been an
Adjunct Professor of Systematic Theology at
the Reformed Presbyterian Theological
Seminary (RPTS) in Pittsburgh since 2007 and
is a former Bible teacher at Heritage Christian
School in Indianapolis. He and his wife Evelyn
have four children-Isaiah, Caroline, Calvin, and Josiah.
Junior High Program: Pastor Jared Olivetti
West Lafayette, IN
Two years later, he was sent out and installed as the church
planting pastor of IRPC. Jared and Lisa, his wife of twelve years,
have five young children.
Please attach all pertinent information to this form and
mail it with the Registration Form, OR have it handdelivered to the Conference Manager at Registration.
Gender
Age
8.
raised up as laborers for Christ's kingdom. He
the associate pastor of the Lafayette RPC.
EMERGENCY PHONE: _____________________________
7.
grew in his passion to see men and women
seminary in Pittsburgh. In 2004, he became
DATE: __________________________________________
Name (continued from front)
involved in the Navigators and through them
the Lafayette RPC and then entered the RP
________________________________________________
REGISTRATION FORM (Continued):
While at Purdue University, Jared became
began an internship with Pastor Dave Long of
PARENT SIGNATURE:
9.
Campbellsville University
1 University Drive
Campbellsville, KY 42718
Registration will be in Ransdell Chapel. Those
paid in full before July 3, 2015 will enjoy express
check-in. There is a key deposit of $10 per key.
10.
11.
12.
Special Needs/Roommate Requests:
________________________________________________
________________________________________________
________________________________________________