2016 RESURRECTION REGISTRATION January 22-24 $30 EARLY BIRD After July 1, 2015, please use the regular registration form ($40 per person) available on the website. This form must be completed in FULL and postmarked by July 1, 2015 in order to receive the $30 per person rate. Church Name: _______________________________________ Denomination: _______________________ District: ____________________________________ Conference:__________________________________ Church Mailing Address: ___________________________________________________________________ Sr. Pastor Name: ______________________________________Sr. Pastor Cell: _______________________ Sr. Pastor Email: _______________________________Youth Leader Email:__________________________ Youth Leader Name: ________________________________ Youth Leader Cell: ______________________ Lodging information maybe found at www.mypigeonforge.com/lodging. This information is required to complete your registration. Hotel/Housing Name: ________________________________ Hotel Phone: __________________________ Registration is first come first served. If your session of choice is full, you will automatically be registered for the other available session. CHOOSE A SESSION January 22-24, 2016 or Session B Payment in full must be received with this form. Please make checks payable to Holston Conference. To Pay by credit or debit card please register online at www.resurrectionyouth.com. CONFIRMATIONS ARE ONLY MADE BY EMAIL! Contact us? 865-293-4137 or [email protected] Mailing Address: Resurrection, PO Box 850, Alcoa, TN 37701 # of Tickets: **Adult/Youth Ratio 1 adult per 5 youth** Youth: _______ Adults: _______ Total: ________ Resurrection is a YOUTH 6th-12th grade event. Families of young children are encouraged to attend RezKidz www.rezkidz.com. Young Adults and College Aged are encouraged to attend Divine Rhythm. ww.divinerhythm.com Total # X $30.00 = Amount Due: $_____________ Clergy Attending: YES OR NO (circle one) Clergy Attending Name: _____________________ Will your group need a deaf interpreter for session A or B? YES or NO (circle one) Will you need a Spanish Translator for session A or B: YES or NO (circle one) ____ I understand by registering for this event, that a photo release form must be turned in with my registration signed by the group leader AND senior pastor. Office Use Only: In an effort to encourage pastors to attend, one senior or associate pastor per church/charge is free. Date Received: _______________ Check #:_____________ Session A Photo Release Form: ______ New Location: LeConte Center 2986 Teaster Lane Pigeon Forge, TN 37863