Winterfest 2025 Student Registration
Please fill out this form and click submit.
Name
*
Student Phone Number
*
Grade
*
Please select one option.
6
7
8
9
10
11
12
Parent/Guardian Name
*
Parent/Guardian Email
*
This address will receive a confirmation email
Parent/Guardian Phone
*
Address
*
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DC
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FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
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MB
MD
ME
MH
MI
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MO
MP
MS
MT
NB
NC
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NJ
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NT
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OK
ON
OR
PA
PE
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PW
QC
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UT
VA
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WA
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YT
Other Emergency Contact Name
*
Emergency Contact Relationship to Student
*
Emergency Contact Phone Number
*
Rooming Request - Name 3-4 students your son/daughter would prefer to room with if possible. Rooming Requests not guaranteed.
*
Would you like to request a full or partial scholarship?
*
Please select one option.
No
Full
Partial (Select this if paying $40 Justlead rate)
Select Option
No
Full
Partial (Select this if paying $40 Justlead rate)
Would you like to provide a full or partial scholarship?
*
Please select one option.
Full
Partial
No
Select Option
Full
Partial
No
Payment
First Child ($125)
Second Child ($115)
Third Child ($105)
Justlead Rate ($40)
I requested a Full Scholarship ($0)
I requested a partial scholarship (Pay what you can here, and we'll find scholarship for the rest)
I will pay by cash/check at a later date. ($0)
First Child ($125)
Second Child ($115)
Third Child ($105)
Justlead Rate ($40)
I requested a Full Scholarship ($0)
I requested a partial scholarship (Pay what you can here, and we'll find scholarship for the rest)
I will pay by cash/check at a later date. ($0)
Amount
Has your insurance changed since filling out a LYF Permission to Treat form
*
Please select one option.
Yes (I need to fill out a new form)
No
I have never filled out a Permission to Treat Form
Parent/Guardian, by typing your full name you are confirming your knowledge and approval of participation in Winterfest with Laurel Youth Fellowship, which includes a trip to Gatlinburg, a hotel stay in Gatlinburg, free time in which students will be allowed to walk the streets of downtown Gatlinburg, and several worship and teaching sessions in the Gatlinburg Convention Center. You also waive all chaperones, the youth minister, and the Laurel Church of Christ of liability in the instance of reasonably unpreventable harm or injury to your child due to participation in this event.
*
Student, by typing your full name you are confirming your knowledge and approval of participation in Winterfest with Laurel Youth Fellowship, which includes a trip to Gatlinburg, a hotel stay at Black Bear Inn and Suites in Gatlinburg, free time in which students will be allowed to walk the streets of downtown Gatlinburg, and several worship and teaching sessions in the Gatlinburg Convention Center. You also waive all chaperones, the youth minister, and the Laurel Church of Christ of liability in the instance of reasonably unpreventable harm or injury to you due to participation in this event. You also agree to accept the responsibilities of following the rules and guidelines as presented by Trey, and if you do not complete the "Winterfest Rules Quiz" you will not be allowed to attend.
*
Credit/Debit Card Number
Expiration Date/CVC
Name on Card
Card Billing Address
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AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Submit
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