URCYA 2018 Registration

urcya

URCYA 2018 Registration

Welcome to the United Reformed Church Youth Assembly registration page. Please fill in all fields below and book before 1 January 2018.



Attendee Details




First Name(s):*

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Surname:*

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Known as (for name badge):*

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Gender:*

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Address:*

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Postcode:*

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Telephone Number:*

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Email:*

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Date of Birth:*

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Age (on 19/1/18):*

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Church Name (if applicable):*

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Synod (or Denomination/College):*

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Have you been to Youth Assembly before?*

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Next of Kin




First Name(s):*

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Surname:*

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Relationship:*

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Email Address:*

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Telephone Number:*

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Mobile Number:*

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Travel




How will you be travelling to Youth Assembly?*

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Day of arrival:*

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A coach will be provided from Tamworth train station to Whitemoor Lakes on Friday 19 January 2018 and returning from Whitemoor Lakes to Tamworth train station on Sunday 21 January 2018. Will you need a seat on the coach?*

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Special requirements




Do you have any special dietary requirements (including vegetarian/vegan, allergies, intolerances, etc.)?

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Do you have a disability?*

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If so, please tell us more:

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Is there anything we can do to help or support you?

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Costs




If money is an issue, please contact us on 020 7916 8683 or e-mail children.youth@urc.org.uk as financial support is available.

The cost of attending the URC Youth Assembly 2018 is:

£110 (on or before 8 November 2017)
£140 (on or after 9 November 2017)

Please tell us how your costs will be paid:



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Amount:

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Name of Synod:

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Band at Youth Assembly





Please tell us if you would be willing to share musical gifts




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I play the:

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Ethnic Diversity




URC Youth Assembly is a safe and welcoming place for all young people, whatever their background or wherever they come from. Please help us to make this happen by telling us about your ethnicity.

I am:


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White Other:

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Black Other:

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Other:

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Other Questions




Most rooms have four beds (usually two singles and one bunk bed). If you would like to share with a friend(s) of the same gender (same or similar age), please state their name(s) here and we will do our best to match you up:

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If you or your group need a leader to accompany you, please get in touch directly with the Children’s and Youth Office on 020 7916 8683 or children.youth@urc.org.uk