CIY MOVE in Holland, MI - June 16th/17th - 22nd 2024

About CIY

CIY (Christ In Youth) MOVE is a week long event for students going into 9th Grade through 2024 Graduates.

Located on college campuses across the nation, MOVE provides a program for 30,000 high school students every summer. Our students will be challenged through intense, interactive worship, dynamic preaching, small group study and community building. At MOVE they will not only learn and worship together – they will spend quality time with our youth group, and discover ways that God will use them to impact the world. MOVE is more than just another conference or camp – it’s an experience! It’s an all-inclusive event providing food, lodging, recreational activities and an amazing program!

Event Information

We will leave the church Monday morning @ 6 am June 16th or Sunday afternoon June 17th. The dilemma being I don't want to take students away from spending time with dads on Father's Day. But I also don't want to burden parents with having to leave at 6 am on Monday morning. So TBD closer to the date.

The event lasts from the time of Check-In on Monday afternoon the 17th until Friday night June 21st. We stay at the college Friday, then leave Saturday morning the 22nd. We should return to the church between 6-7pm on Saturday night.

Thursday morning to evening is called Extended Rec. It gives youth groups an opportunity to go off campus and do something fun together. This year we will be going to the beach!

The cost in this registration does not include the money for meals or a T-Shirt.

Please send money for:

Sunday - Dinner (if we leave Sunday)

Monday - (I'll cover breakfast), Lunch

Thursday - Lunch

Saturday - Breakfast, Lunch, possibly dinner

6 meals at a suggested $9-10 a meal = roughly $54 - $60 for meals on the road.

WHAT TO BRING:

Bible

Notebook & pen/pencil

Clothing for 7 days (see dress code below)

Swim Suit - (Ladies: one piece or dark t-shirt over)

Toiletry items (soap, shampoo, toothbrush/paste etc.)

Medications (Let Dana know what you have and when you need to take it)

Towel (2 is better so that you have one for other water stuff besides showering)

Pillow

Bedding to fit a single bed or a sleeping bag

Bag for dirty laundry

Sunscreen

Optional Suggestions:

Bug spray, shower shoes, alarm clock - I don't allow much cell phone use during the week!

Money for souvenirs, MOVE store (T-Shirt, etc.), on the way, Offering

Student Information

Student's Name

Gender

Male
Female

Student's Phone Number

Yes, it's okay to send me text messages including confirmations, changes, updates, and/or promotions. Message frequency varies. Message and data rates may apply. View our terms of service & privacy policy.

Date of Birth

Grade (in the fall)

Address

T-Shirt Size

*For the remainder of this form the term "Student" will refer to the minor mentioned above that is going into 9th - 12th grade or High School graduate. If the "Student" named above is 18, with their parent(s) or guardian(s) permission they may fill the form out themselves.

Parent/Guardian Information

Primary Parent/Guardian

Relationship to Student

Student lives with this person

If "Other Guardian" please specify

Phone Number

Address (if different than Student's)

Confirm Email

Secondary Parent/Guardian

Student lives with this person

Relationship to Student

If "Other Guardian" please specify

Phone Number

Address (if different than Student's)

Emergency Contact Information

In case of emergency, we will attempt to contact the primary parent/guardian first, followed by the secondary parent/guarding. If you have someone who you would like to add as an emergency contact in the rare scenario that we cannot reach either parent or guardian please list them here.

Emergency Contact (other than primary or secondary)

Relationship to Student

Phone Number

Medical Information

If necessary, describe in detail the nature and severity of any physical and/or psychological ailment, illness, propensity, weakness, limitation, handicap, disability, or condition to which your Student is subject and of which the staff should be aware, and what, if any action of protection is required on account thereof.

Does your Student have any allergies that we need to be aware of?

Does your Student suffer from, has ever experienced, or is being treated currently for any of the following:

Does your Student wear:

Glasses
Contacts

ACTIVITIES MAY INCLUDE, BUT ARE NOT LIMITED TO: LOUD MUSIC WITH LIGHT SHOWS. GAGA BALL, 9 SQUARE IN THE AIR, BASKET BALL, VOLLEY BALL, DODGEBALL, ETC. IF YOU WISH TO LIMIT YOUR STUDENT’S PARTICIPATION IN ANY OF THESE OR NON-LISTED EVENTS PLEASE LIST AND EXPLAIN IN THE BOX PROVIDED:

Permissions

The Student mentioned in this form has my permission to ride to Hope College in Holland, Michigan with Hillsboro Christian Church's 412 Student Ministry in a church authorized vehicle driven by either the Student Minister or a background checked adult volunteer on June 16th, 2024 and returning on June 22nd 2024

I give Hillsboro Christian Church permission to use any pictures and/or videos taken of my Student for promotional use, (slides, printed materials, videos, etc.)

I give Hillsboro Christian Church and 412 Student Ministry permission to publish any pictures and/or videos take of my Student on their social media platforms, such as the 412 Student Ministry Facebook Page or Instagram Page, the Hillsboro Christian Church Facebook Page, or the Hillsboro Christian Church Website. (Hillsboro Christian Church will not "TAG" your Student on any of the above mentioned sites.)

Code of Conduct

-No possession or use of alcohol, drugs, tobacco, or juuling/vaping or any other kind of e-cigs.

-No fighting, weapons, fireworks, lighters, explosives, or any other activity that may cause body or property damage.

-No offensive language (swearing, cussing, sensual, sexual, inappropriate jokes, etc.)

-No PDA (Public Display of Affection, students will hear it referred to as "NO PURPLE!". Guys are blue, girls are red. Don't mix

the two) We do not allow guys and girls to kiss, hold hands, hug for extended periods of time or any other form of touch,

embrace etc. that would be considered affectionate or sensual/sexual in any way. If students have a boy/girl friend here and

are allowed to do any of that elsewhere they will be expected/asked to refrain while a part of our event or parents will be

contacted and they will potentially be sent home.

-No offensive or immodest clothing as listed below:

-No tank tops, spaghetti straps, or showing of the midriff

-No pants with writing on the back side

-No short shorts, dresses or skirts

-No sagging – no underwear showing because pants/shorts are too low

-No holes in inappropriate places

-In all matters of clothing modesty is the best policy.

-A student not complying with the dress code above will be asked to change or be sent home to change.

-No boys in girls’ sleeping quarters and no girls in boys’ sleeping quarters.

-No leaving the facility without the Student Minister (Dana Kennard) receiving parent/guardian permission. If a student leaves without permission we will be forced to call parents and or authorities as we will at that point label the student as "missing".

STUDENTS WHO FAIL TO COMPLY WITH THESE EXPECTATIONS MAY BE SENT HOME/PICKED UP AT THEIR PARENTS’/GUARDIANS’ EXPENSE.

The Student is also expected to:

-Participate with the group.

-Respect property.

-Respect one another, staff, and adult leaders.

-Respect and comply with event schedules.

Please check the box if the above mentioned Student has read and agrees with the Code of Conduct stated above:

Terms & Agreement

This consent form gives permission for your Student to attend the above mentioned event and to seek whatever medical attention is deemed necessary, and releases Hillsboro Christian Church, its staff or any of its volunteers of any liability against personal losses of named Student. I, the undersigned have legal custody of the Student named above, a minor, and have given my consent for him/her to attend this event being organized by Hillsboro Christian Church off campus. I understand that there are inherent risks involved in any off campus event, and I hereby release Hillsboro Christian Church, its ministers, employees, agents, and volunteer workers from any and all liability for any injury, loss, or damage to person or property that may occur during the course of my Student’s involvement. In the event that he/she is injured and requires the attention of a doctor, I consent to any reasonable medical treatment as deemed necessary by a licensed physician. In the event treatment is required from a physician and/or hospital personnel designated by Hillsboro Christian Church, I agree to hold such person free and harmless of any claims, demands, or suits for damages arising from the giving of such consent. I also acknowledge that I will be ultimately responsible for the cost of any medical care should the cost of that medical care not be reimbursed by the health insurance provider. Further, I affirm that the health insurance information provided above is accurate at this date and will, to the best of my knowledge, still be in force for the student named above. I also agree to bring my Student home at my own expense should they become ill, injured or if deemed necessary by the Hillsboro Christian Church’s Student Minister (Dana Kennard), any of the other paid staff or background checked Adult Volunteer Leaders. If you agree to the above terms please sign below:

I, the undersigned, agree to the terms above.

Name of person completing this form

18 or older

I am 18 or older and I am filling out this form for myself. I am the "Student" mentioned above.

I am the legal Parent/Guardian of the Student mentioned in this form*

Date Signed

Full Payment: CIY MOVE Event

Deposit ($430.00)
*You can pay the full amount now or choose the deposit option below. If you only pay the deposit the balance will automatically be withdrawn on June 15th from the card provided.

Coupon Code

Total

$430.00

If you need help with the cost please send me (Dana Kennard, the Student Minister) a message and I will send you a coupon code.

Billing Information

Name

Credit Card

Visa
Mastercard
American Express
Discover

Address