Middle School All-Nighter 2018 – Riverchase Student Ministries

The Middle School All-Nighter is coming! The event will be on November 16th from 10pm-8am. This is an awesome event just for Middle School students. We will stay up all night long together, play a ton of fun games, and have some brand new surprises! The cost for the night is $40, and each student must have a waiver (attached below) signed by a parent or guardian in order to participate. We can not wait to see you at the All-Nighter! if you have any questions please email info@riverchasestudents.com.

Please print and fill out the All Nighter Waiver and turn it in when you arrive or to youth office prior to the 16th.

"*" indicates required fields

Student Info

Student's Name*

First Last

Student's Age*

Student's Grade*

Student's Gender*

Student's School*

Student's Cell Phone

Student's T-Shirt Size*

*Adult sizes only

Is student a visitor?

Yes

If student is a visitor, who were they invited by?*

Will student be leaving at any point during the weekend?

Yes

When will the student be leaving?*

Please note day and time.

When will the student return?*

Please note day and time.

Does student have any special needs or dietary restrictions?

Does student take any medications that require an adult to assist with administering?

Please list any medications and any necessary instructions.

Parent Info

Parent/Guardian (Primary Contact)*

First Last

Other Parent/Guardian - Name

First Last

Parent/Guardian - Cell Phone*

This number will receive text updates prior to and throughout Discovery Weekend to communicate information and reminders.

Other Parent/Guardian - Cell Phone

Parent/Guardian Email*

Are you willing to be contacted about chaperoning this event?

Media Release

Attention: By submitting this form you thereby give permission for photographs/videos from this event in which your child appears to be used for publications and public relations activities by Riverchase United Methodist Church. This usage may include use in print media, electronic media, and social media. Please email the RSM Youth Staff at info@riverchasestudents.com if you DO NOT wish for photos/videos of your child to be published in church publications.

Payment

Payment Options*

Credit/Debit Card Payment

Scholarship Payment

Optional Scholarship Donation

If you would like to help provide funds for a student scholarship to attend the BigStuf Retreat, please insert the amount above.

Scholarship Code

If you would like to request a scholarship please contact Taylor Sallade at TaylorS@riverchaseumc.org

Registration Fee

Price:

Registration Fee

Price:

Total

Payment Method

Name

This field is for validation purposes and should be left unchanged.

Middle School All-Nighter 2018
October 30th, 2018

Student Info

Parent Info

Payment

Hey Parents!

Middle School All-Nighter 2018 October 30th, 2018

Student Info

Parent Info

Payment

Hey Parents!

Middle School All-Nighter 2018
October 30th, 2018