THE CHURCH OF CHRIST WRITTEN IN HEAVEN, INC. 11 TH NATIONAL YOUTH CONVENTION July 17-21, 2013 REGISTRATION FORM Visit our website at
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1 PLEASE PRINT (Separate form for each attendee) THE CHURCH OF CHRIST WRITTEN IN HEAVEN, INC. 11 TH NATIONAL YOUTH CONVENTION July 17-21, 2013 REGISTRATION FORM Visit our website at NAME ADDRESS: CITY STATE ZIP PHONE CELL WORK FAX Please select all that applies: The Youth Convention is looking for willing workers to volunteer to work in the following areas: I will work with the Registration Committee I will serve as a Prayer Warrior* I will serve as a Greeter/Hospitality I will work with Security (needs adults with pastor s recommendation only) LOCAL CHURCH NAME PASTOR YOUTH PRESIDENT PRESIDENT PHONE # PARENT/GUARDIAN SIGNATURE (if under 18) EMERGENGY CONTACT PHONE CELL SPECIAL DIET (Banquet) I will serve as an Usher I will serve as a Nurse I will work with the Praise Team Please select one of the following to participate in: I will participate in the Golf Outing I will participate in the Basketball Shoot Around and/or three on three *Prayer Warriors will meet in the Prayer Room daily Contact Bishop W. J or newholycross@verizon.net or Bishop A. T or screenat53@aol.com for additional information regarding any of the above program activities, participants and convention workers Arrival date: Departure date: (PAYMENT MUST BE RECEIVED OR POSTMARKED BY SPECIFIED DATES) Convention Registration Fee Registration Fee Banquet Convention T-Shirts T-Shirts 3X up (add a dollar for each additional X) Until 4/1 4/2 thru 6/17 S -2X Adults $15.00 $20.00 $30.00 $12.00 $15.00 plus Teens (15-17) $7.00 $10.00 $30.00 $10.00 T-Shirt Size Teens (12-14) $7.00 $10.00 $30.00 $10.00 S, M, L, XL, 2X, 3X, Pre-Teens (9-11) $5.00 $7.00 $15.00 $8.00 4X, 5X, Children (up to 8) Free Free $15.00 $8.00 Child: S, M, L, XL Please make checks or money orders payable to the Church of Christ Written in Heaven Total Amount Pd If you have not made your hotel reservations, please go to: Or call Marriott Central Reservations at (800) , ask for the Church of Christ WIH group rate. You will need a credit card. No charges will be made to your card at the time you make your reservations. Please mail completed form to: Mother Dorothy Rivers, 2488 Eddie Road, Tallahassee, Florida For additional registration information please call Mother Rivers at (850) or Mother Rivers at searivers11@gmail.com. Total Due
2 2013 National Youth Convention Church of Christ Written in Heaven, Inc. The 11 th National Youth Convention is fast approaching and early bird convention registrations and early bird hotel reservations are the order of the day. Please pray with us that God will bless us to come together to magnify His name. General Information: Convention Registration Early Bird Convention Registration will begin on Tuesday, January 22, 2013 and will end on Monday, April 1, 2013 Regular registration will remain open until Monday, June 17, 2013 There will be a special drawing for Early Bird Convention Registrations All religious services and programs will be held at the Marriott Convention registration form is available at www. cocwih.com Children s Luncheon with the National Youth President will be for children up to age 11 Banquet tickets can be purchased until June 30 th If you paid your convention registration fee early and can not attend the convention, you will receive a refund if you cancel your convention registration before June 17 th. No refund will be issued after June 17th. Hotel Reservation Information Early Bird Hotel Reservations will begin on Tuesday, January 22, 2013 and end on Monday, March 4, Convention rate is $99.00 per night plus 13% sale tax Regular hotel reservations will remain open until Monday, April 15th Hotel reservations can be made on line at: todate=7/22/13 You can also call Marriott Central Reservations at (800) and ask for the Church of Christ WIH group rate All reservations must be guaranteed with a major credit card Hotel will continue to accept reservations until June 17 th, if rooms are available. After that date you might not be able to get the group rate but a regular rate of $ Churches using a rooming list and their church credit card to guarantee their rooming list: Churches doing a rooming list may fax their list with a copy of their tax-exempt certificate to or Jennifer.hercher@pinnaclehm.com. Churches using a rooming list must pay for their rooms by Monday, July 8, 2013 Any hotel room cancellations, no shows, or early departures without a 24 hours advance notice will result in forfeiture of one night deposit or a charge of one night s stay to the credit card used to guarantee the reservation
3 11th National Youth Convention COCWIH Debutante and Gentlemen s Youth Formal Purpose This premier event will formally introduce our young ladies and young gentlemen to the banquet attendees and convention delegates. It will allow our young ladies to dress in formal gowns and the young men to dress in suits and ties. Being a participant requires time, hard work, and dedication, but will reap great rewards and a variety of program incentives. This event is designed to give our youth the opportunity to develop positive self-esteem, to demonstrate their support for the national youth department and to provide a greater educational opportunity for our youth. The funds generated from the Formal will go toward our scholarship fund Benefits The male and female participants, who report the highest amount, will be crowned Mr. and Miss National YPCW and National YPCW Prince and Princess. Each individual will receive 25% of their gross receipts in consideration of their personal efforts. Mr. and Miss National YCPW will preside during the convention and give a coronation address. The Prince and Princess will assist the Mr. and Miss during the convention. Formal Requirements Each female participant is ask to wear a white gown and white gloves Each male participant is ask to wear a black suit, white shirt and black tie Junior female participant is ask to wear a royal blue gown or dress Junior male participate is ask to wear a black suit, white shirt and black tie Debutantes and Gentlemen will be asked to solicit sponsorships from family, friends, and local businesses in support of their participation in this contest. Eligibility for Formal Participants Males and females between the ages of Must be a member of a COCWIH Church YPCW Department Application submittal must meet all deadlines Eligibility Juniors (Prince and Princess Participants) Males and females between the ages of 5-11 Must be a member of a COCWIH Church YPCW Department Application submittal must meet all deadlines Entry Date Entries must be submitted by April 2, 2013, to the formal Chairperson, Evangelist Annie Grady, 5975 Button Willow Lane, Tallahassee, Florida Closing Date The Formal closing date is July 7, All monies must be postmarked by that date. Mail payments to Deacon Clarence Rivers, 2488 Eddie Road, Tallahassee, Fl Make checks payable to the Church of Christ Written in Heaven. Additional Information Please call Evangelist Annie or Deacon Clarence
4 11th National Youth Convention COCWIH Debutante and Gentlemen s Application Please Print: Name Address City State Zip Local Church Name Pastor Pastor Phone Number Youth President Youth President Phone Number Parent or Guardian s Signature (If under age 18) I agree to abide by the rules of this formal and I will accept the decision of the committee as final. Applicant s Signature Date Completed Return completed form by April 2, 2013 to: Evangelist Annie Grady 5975 Button Willow Lane Tallahassee, Florida or agrady1st@aol.com
5 Please Print: 11th National Youth Convention COCWIH Prince and Princess Formal Application (Junior contestants) Name Address City State Zip Local Church Name Pastor Pastor Phone Number Youth President Youth President Phone Number Parent or Guardian s Signature (If under age 18) I agree to abide by the rules of the formal and I will accept the decision of the committee as final. Applicant s Signature Date Completed Return completed form by April 2, 2013 to: Evangelist Annie Grady 5975 Button Willow Lane Tallahassee, Florida or agrady1st@aol.com
6 Church of Christ Written in Heaven, Inc. 11 th National Youth Convention July 17 21, 2013 Orlando Marriott Lake Mary Lake Mary, Florida Bishop Willie J. Jones, Senior Presiding Bishop & National Youth Bishop Debutante and Gentlemen s Ad Form I am a contestant in the Debutante and Gentlemen s Contest for the National Youth Convention 2013 and am requesting your financial support. With the purchase of an ad, my picture and your congratulations will be placed in our souvenir journal. Please select from one of the following ads and thank you for your support: PLEASE SELECT: Please Print 1/8 page $25.00 black & white 1/4 page $35.00 black & white 1/2 page $50.00 black & white Whole page $ black & white 1/2 page $75.00 color Whole page $ color Name: MESSAGE: Please correspond with the contestant that an ad was taken out in their name but send the ad along with a check or money order payable to Church of Christ Written In Heaven, to Evangelist Annie Grady, 5975 Button Willow Lane, Tallahassee, Florida by Monday, June 24, Please provide the name of the contestant you are sending in your ad for on the line provided: Contestant s Name:
7 Church of Christ Written in Heaven, Inc. 11 th National Youth Convention July 17 21, 2013 Orlando Marriott Lake Mary Lake Mary, Florida Bishop Willie J. Jones, Senior Presiding Bishop & National Youth Bishop Prince and Princess Ad Form I am a contestant in the Prince and Princess Contest for the National Youth Convention 2013 and am requesting your financial support. With the purchase of an ad, my picture and your congratulations will be placed in our souvenir journal. Please select from one of the following ads and thank you for your support: PLEASE SELECT: Please Print 1/8 page $25.00 black & white 1/4 page $35.00 black & white 1/2 page $50.00 black & white Whole page $ black & white 1/2 page $75.00 color Whole page $ color Name: MESSAGE: Please correspond with the contestant that an ad was taken out in their name but send the ad along with a check or money order payable to Church of Christ Written In Heaven, to Evangelist Annie Grady, 5975 Button Willow Lane, Tallahassee, Florida by Monday, June 24, Please provide the name of the contestant you are sending in your ad for on the line provided: Contestant s Name:
8 Church of Christ Written in Heaven, Inc. 11 th National Youth Convention July 17 th through July 21 st 2013 Orlando Marriott Lake Mary Lake Mary, Florida Bishop Willie J. Jones, Senior Presiding Bishop & National Youth Bishop Souvenir Journal AD FORMS PLEASE SELECT: Patron List Single Name - $3.00 Mr. & Mrs. $5.00 Ads & Greetings, In Memory of 1/8 pages $25.00 black & white Attach Business Card here: 1/4 pages - $35.00 black & white ½ pages - $50.00 black & white Whole page - $ black & white Please Print ½ pages - $ color Whole page - $ color Name: _ Auxiliary/Address: _ MESSAGE: PLEASE RETURN THIS FORM BY Monday June 10, 2013 TO: Evangelist Annie Grady, 5975 Button Willow Lane, Tallahassee, Fl ~ or to agrady1st@aol.com. If you your ad, please send check to the above address. Make Checks Payable to: Church of Christ Written In Heaven
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