KAIO Conference Registration Form

KAIO Conference Registration Form
Registration Type*

Student(s)Youth Worker (Adult leader accompanying youth)
Number of Students*

Student 1 Information
Full Name*

First NameLast Name
Email*
example@example.com
Grade (Incoming Fall 2026)*
Affiliated Church Name
Church State
Gender*

MaleFemale
Do you have any food allergies or dietary restrictions?*

YesNo
Please describe your allergies or dietary restrictions:

Student 2 Information
Full Name*

First NameLast Name
Email*
example@example.com
Grade (Incoming Fall 2026)*
Gender*

MaleFemale
Affiliated Church Name
Church State
Do you have any food allergies or dietary restrictions?*

YesNo
Please describe your allergies or dietary restrictions:

Student 3 Information
Full Name*

First NameLast Name
Email*
example@example.com
Grade (Incoming Fall 2026)*
Gender*

MaleFemale
Affiliated Church Name
Church State
Do you have any food allergies or dietary restrictions?*

YesNo
Please describe your allergies or dietary restrictions:

Student 4 Information
Full Name*

First NameLast Name
Email*
example@example.com
Grade (Incoming Fall 2026)*
Gender*

MaleFemale
Affiliated Church Name
Church State
Do you have any food allergies or dietary restrictions?*

YesNo
Please describe your allergies or dietary restrictions:

Student 5 Information
Full Name*

First NameLast Name
Email*
example@example.com
Gender*

MaleFemale
Affiliated Church Name
Church State
Do you have any food allergies or dietary restrictions?*

YesNo
Please describe your allergies or dietary restrictions:

Youth Worker Registration
Full Name*

First NameLast Name
Email*
example@example.com
Gender*

MaleFemale
Church Name*
Church State*
Your Role at Church
Do you have any food allergies or dietary restrictions?*

YesNo
Please describe your allergies or dietary restrictions:

Guardian & Emergency Contact
Emergency Contact
Full Name*

First NameLast Name
Email*
example@example.com
Relationship*
Phone Number*
Please enter a valid phone number.

Agreements & Consent Forms
Parent / Guardian Consent
I give my child permission to attend KAIO Conference during July 20-23, 2026 at Illinois Wesleyan University. I am aware that my child as a participant of this retreat, must abide by all rules and regulations and assume responsibility for his/her actions.
Consent Required*

I Agree
Behavior and Compliance Policy
I have read and agree to comply with the Behavior and Compliance Policy outlined for this event which is stated on the KAIO website.
Consent Required*

I Agree
Release of Liability Consent
In the event that any accident or injury should occur involving my child, I will hold no liability against KAIO Conference, Covenant Fellowship Church, Illinois Wesleyan University, or any of their staff or representatives.
Release of Liability Consent
In the event that any accident or injury should occur, I will hold no liability against KAIO Conference, Covenant Fellowship Church, Illinois Wesleyan University, or any of their staff or representatives.
Consent Required*

I Agree
Medical Consent
As may be deemed necessary, I give permission for non-prescription medication (e.g. Tylenol, Advil, Mylanta, Etc.) to be issued to my child, and I authorize any medical treatment by a physician or nurse to be administered to my child if any accident or injury occurs. In such a case, I will assume the responsibility of all medical bills.
Consent Required*

I Agree
Signature

Clear

Complete Your Registration
KAIO Merchandise Pre-Order

Interested in pre-ordering KAIO merchandise at a discounted rate? Order our merch below.

T-Shirt - $15 ($20 at conference)

Hoodie - $40 ($50 at conference)
KAIO T-SHIRT
Youth L (14-16)
Adult Small
Adult Medium
Adult Large
Adult XL
KAIO HOODIE
Youth L (14-16)
Adult Small
Adult Medium
Adult Large
Adult XL

Payment Amount

USD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

REGISTRATION TOTAL
TSHIRT TOTAL
HOODIE TOTAL
SUBTOTAL
Should be Empty: