Registration/Permission Packet Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.

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Event Description
Tough Talk is a Christian conference for youth ages 12-18. Tough Talk features workshops lead by youth ministers and leaders from across the Metropolitan Detroit Area that tackle the hard hitting issues of sexuality, abstinence, and self-esteem. Tough Talk will also feature workshops on empowerment and life skill development. This year, Tough Talk will be a lock-in held on Friday, October 26 starting at 7:00pm and ending at 10:00am on Saturday Morning October 27th. PARENTAL PERMISSION IS REQUIRED TO ATTEND! Registration is Free but there are only 50 spots available on a first come first serve basis. Permission/Registration Forms will be available at Serenity Christian Church, on our Website (www.serenitychristianchurch.org) and on Facebook (Event Search: TOUGH TALK 2)

Event Hosts

TOUGH TALK is hosted by Serenity Christian Church and the ministries Under the Rug and Ambassadors for Christ. Under the Rug s mission is to equip Christians with the necessary skills to address, discuss, and break free from sexual sin. Under the Rug has hosted such events as Homosexuality 101, Porn Sunday, and The Truth About Masturbation. Ambassadors for Christ is Serenitys children and youth ministry with the mission to REACH students, to CONNECT them with other Christians, to help them GROW in their faith so they can EXPLORE their spiritual gifts in order to HONOR God. TOUGH TALK brings together these two powerful ministries to specifically deal with the issues faced by todays youth. This years conference leaders are Benjamin Williams (Under the Rug) and Jasmine McCord (Ambassadors for Christ)

All Workshop Leaders/Volunteers are Professionals In Their Ministry

Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com

Registration/Permission Packet Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.org

EVENT SCHEDULE
Friday October 26th, 2012 7:00pm-10:00am (Saturday Morning) @ Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030
7:00pm-8:00pm 8:00pm-9:00pm 9:00pm-2:00am 2:00am-8:00am 8:00am 8:30am 9:00am 9am-10am Drop-Off/Ice Breakers/ with Parents (Parents must stay until 8:00pm) Dinner Workshops Lights Out (Girls and Boys will be separated to designated sleeping areas with chaperons) Wake-Up Call 1 Wake Up Call 2 Parents Arrive Breakfast and Workshop Discussion with Parents (Parents must attend this workshop)

Call 313-915-0292(Benjamin) or (313) 970-8739(Jasmine) for any questions.

WHAT TO BRING

Bible (we have extras you can borrow if you don't have one yet) Sleeping bag/ mat/ blankets Pillow Pajamas (make sure they are appropriate for church) Toothbrush and paste Change of clothes (in case you get dirty, wet or both) Snacks to share (if youd like) You may bring video games/board games (They must be multiplayer games without any inappropriate content such as cursing or explicit violence, and you will be responsible for keeping up with what you bring)

WHAT NOT TO BRING

iPods MP3 Players Handheld Electronic Games (Nintendo DS, PSP) Valuables (Jewelry, Designer Clothes) Laptops

Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com

Registration/Permission Packet Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.org

REGISTRATION FORM
PARENTAL PERMISSION IS REQUIRED FOR YOUR YOUTH TO PARTICIPATE Please complete the attached Registration Form and Medical Waiver and return to Benjamin Williams or Jasmine McCord. Your youth must have all materials turned in to participate in the conference. Youth Name: ______________________________________________________________Age: ____________ Address: ___________________________________________________________________________________
Street City State Zip

Youth Cell Number:__________________________ Other Phone: _____________________________________ Youth Email: _______________________________ Parent/Guardian Name: ______________________________________________________________________ Cell Phone:__________________________________ Other Phone: __________________________________ Parent Email:________________________________ Emergency Contact Name:____________________ Emergency Contact Number:________________________ Emergency Contact Relationship to your child:__________________________________

PARENT/YOUTH CONTRACT
I____________________ agree to the following as a condition of my participation in TOUGH TALK:
I will attend all scheduled sessions I will arrive on time, prepared, and cooperative. I will respect my leaders and other participants in the program. I understand that this is a Christian Conference that will cover topics that include Sex, Sexuality, Puberty, Abstinence, Youth Empowerment, Life Skills, and Leadership. My parent(s)/guardian(s) understand that this is a Christian Conference that will cover topics that include Sex, Sexuality, Puberty, Abstinence, Youth Empowerment, Life Skills, and Leadership. I will be a mature young person during all discussions and workshops I will have fun!

Youth Signature: _________________________________________________Date:___________________ Parent Witness Signature:__________________________________________________ Date:___________ Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com

Registration/Permission Packet Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.org

MEDICAL WAIVER
Please complete the attached Registration Form and Medical Waiver and return to Benjamin Williams or Jasmine McCord. Your youth must have all materials turned in to participate in the conference. Youth Name: ______________________________________________________________Age: ____________ Address: ___________________________________________________________________________________
Street City State Zip

Youth Cell Number:__________________________ Other Phone: _____________________________________ Youth Email: _______________________________ Parent/Guardian Name: ______________________________________________________________________ Cell Phone:__________________________________ Other Phone: __________________________________ Parent Email:________________________________ Emergency Contact Name:____________________ Emergency Contact Number:________________________ Emergency Contact Relationship to your child:__________________________________ Does your child have any allergies or reactions? (i.e. food, medication, etc.): No___ Yes___ If Yes, please explain: ______________________________________________________________________________ Will your child be taking any medications or treatments during their participation in TOUGH TALK? No___ Yes___ If Yes, please explain: ______________________________________________________________________________ WAIVER: I authorize Serenity Christian Church staff, ministers, and volunteers, to transport the above named participant to the nearest hospital in case of injury or illness while the participant is attending TOUGH TALK if the parent/guardian cannot be reached. I further authorize the hospital attending physician to administer necessary emergency professional medical care to my child. Parent/Guardian Signature: ______________________________ Date__________________

Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com