2023 IBCS Youth Conference

The rest of the registration form, including medical insurance information and permission to attend, must be filled out only by a parent or a legal guardian. Only a parent or a legal guardian is authorized to give permission and to indicate agreement with the policies stated below.

Parent/Guardian Name*

First NameLast Name

Parent's Phone Number

Area CodePhone Number

Parent's Email*

example@example.com

Emergency Contact Name*

First NameLast Name

Emergency Contact Number*

Explain below any permanent or temporary medical or other conditions your child experiences, if any exist, including special dietary or medication needs. IBCS may not be able to accommodate all dietary restrictions.

Medical Insurance Company*

Policyholder*

Policy Number*

I give permission for my child to attend the 2024 IBCS Youth Conference at International Baptist College & Seminary*

YesNo

I understand that my child is expected to follow all IBCS policies.*

YesNo

I understand that smoking and vaping products, alcohol, marijuana, and illegal drugs are prohibited on the IBCS campus and have discussed this with my child.*

YesNo

I confirm that my child has no physical condition(s) that will limit participation in the full range of activities being planned, except as listed above.*

YesNo

I agree to release IBCS from all claims and liabilities that arise from the activities of the conference, except if due to negligence of IBCS.*

YesNo

In case of medical emergency, when I cannot be reached by phone, I authorize the staff of IBCS to secure appropriate medical treatment, such as X-ray, anesthesia, injection, medical or surgical diagnosis or treatment, and hospital care necessitated for my child by injury or illness.*

YesNo

I agree to be responsible for the expense of medical aid where not covered by the IBCS accident insurance policy.*

YesNo

If you have concerns about your child appearing in photographs of the conference, please contact the IBCS office at 480-245-7903.

I understand that I am responsible to see that students from my group understand and follow all IBCS policies.*

YesNo

I understand that smoking and vaping products, alcohol, marijuana, and illegal drugs are prohibited on the IBCS campus and that students who violate this policy will be removed from campus and placed under my direct care.*

YesNo

I agree to release IBCS from all claims and liabilities that arise from the activities of the conference, except if due to negligence of IBCS.*

YesNo

In case of medical emergency, if neither I nor my emergency contacdt are able to order treatment, I authorize the staff of IBCS to secure appropriate medical treatment for me such as X-ray, anesthesia, injection, medical or surgical diagnosis or treatment, and hospital care necessitated by injury or illness.*

YesNo

I agree to be responsible for the expense of medical aid where not covered by the IBCS accident insurance policy.*

YesNo

Official Signature

If you have a coupon code, type it here.

Please check the box below, then proceed to payment.*

Attendance of child at IBCS Youth Conference 2024$70.00

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2025 IBCS Youth Conference Registration

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Medical Insurance Information

Parental Permissions & Policies

Sponsor Permissions & Policies

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