Student Registration

Please use blue or black ink & print clearly. Fill in all blanks.

First Name____________________ Last Name ______________________ Male Female

Address__________________________________ City / State_________________________ Zip___________

Phone ( )________________________ Grade_________ Year of Graduation____________ Age________

Church Youth Director/Pastor Brenneman Missionary Church / Matt Ransom

I would like to room with (one name only):________________________________________________

Deadline: November 4th Registration Cost: $150

Additional Items For Purchase
Rewind DVD Only Add $10: $_______
Shirt only (circle size) S M L XL 2XL Add $12: $_______
or
Epic Bag* (circle size) S M L XL 2XL Add $20 $_______
*includes drawstring backpack, above 2 items (DVD and shirt), & much more!

TOTAL COST: $_______

We (student & parent) have read the 3DYC Guidelines and agree to abide by them. As parent/legal guardian,
I also give permission to have video or pictures taken of my student to be used for promotional purposes. I give
permission for full participation in all activities unless otherwise indicated.
In the event of an emergency, I authorize the 3DYC Director or his representative to grant permission for
medical treatment by a qualified nurse, doctor, or hospital for the person registered on this form, to, from and
during 3DYC, December 28 - 30, 2009.
List any medical problems or medications which should be taken into consideration in the event of an
emergency:
________________________________________________________________________________________________________

____________________________________________________________

Signature required by both student & parent!

_______________________________________ ______________________________________
Student Signature Parent Signature (required regardless of student age)

Emergency phone number: ( )__________________ Date:______________________

Sorry, All Money is Non-Refundable!

Has God blessed you with a special gift or talent that up until now has been hidden or 3 DYC Guidelines
Remember as you are in the hotel and
underappreciated by friends and family? If so, then Epic Spotlight wants YOU! convention center, that you represent your
church and the entire Missionary Church.
Therefore, you should always be on your
Replacing our traditional talent competition that limited participation to singing, playing an best behavior and obey the rules of each
area.
instrumental solo or preaching, and was based purely on quality, Epic Spotlight breaks new
1. Any inappropriate behavior will not
ground, expanding to new frontiers of entertainment such as juggling, magic, rhythmic be tolerated. Those involved will be
disciplined, required to call their
parents to explain their misbehavior,
gymnastics, stand-up comedy, chalk art, contortionists, skits, ventriloquism, beauticians, as well and/or be sent home at their own
expense. If your behavior is unlawful,
as the more traditional talent categories. The possibilities are endless. the local law enforcement agency will
be contacted.
2. You are not allowed to write on the
hotel windows. Each violation will
ROUND ONE: All entries will be assigned an audition slot during which they will perform before result in a $10 fine.
3. Modesty is required at all times.
Pajamas are not to be worn outside of
a panel of qualified judges, who will then determine whether their talent is worthy of a your room. Remember that other
guests are using the hotel. Other
call-back audition. people and businesses can see in your
window, so be sure to close your
ROUND TWO: Those selected to continue on to the second round will again appear before a curtains when changing clothes, etc.
Curtains must remain closed from 9
panel of judges who will determine if the performance is worthy of sharing the Epic Spotlight p.m. to 9 a.m. Intentional immod-
esty will be dealt with.
with the best of the best. 4. Walkie talkies, roller blades and
skateboards are NOT allowed.
5. You must wear your name tag
EPIC SPOTLIGHT: Those selected to perform live onstage in front of 3DYC will compete for around your neck at all times. It is
your pass to attend the general
awesome cash and prizes, including $250 cash, iPods, game systems, and much much more! sessions and participate in all activities.
Without it you may not be admitted
to meals and activities and may be
questioned by security. If you leave it
Talent__________________________________ Grade_____ Is this a group entry? Yes/No in your room, you will be sent back to
get it. If it is lost or damaged, you may
purchase a new one in the 3DYC office
If Yes, who are the other members_________________________________________________ for $5.00.
6. Your church is responsible for any
room damages and will be billed
Dodgeball accordingly. If you move something
(blanket, pillow, etc.) to another
room, you will be charged for it if it is
Name:_______________________________ Grade: _________ not returned to the original room.
7. Absolutely no guys on girls’ floors and
Max 8 players per team, You are allowed to have two sponsors. no girls on guys’ floors! No exceptions
will be made for devotions, meetings,
etc. Any guy caught on a girls’ floor or
1. any girl caught on a guys’ floor will be
warned or sent home. Any guy caught
2. in a girls’ room and any girl caught in
a guys’ room will be sent home!
3. 8. You may not practice instruments
between 9:00 p.m. and 8:00 a.m.
4. 9. Everyone is required to attend all
general sessions.
10. You may not leave the hotel/
5. convention center without being
accompanied by your Youth Director
6. or an Adult Leader.
11. The phones in your room are for your
c o n ve n ien c e an d n ot y ou r
7. entertainment. Misuse will result in
phones being removed from the room.
8. 12. Everyone is to be in their own hotel by
11:45 p.m. and in their own room by
12:00 midnight.
13. The hotels, convention center and
3DYC are not responsible for lost or
stolen items.
PLEASE NOTE: Everyone who attends 3DYC will have 14. Please keep cell phones from being a
distraction during General Sessions.
the privilege of playing on a Rally Ball Team!

Sorry, All Money is Non-Refundable!