Westside Christian Church - CIY MIX 2024 (Middle School)

Step 1: REGISTRATION FORM

MIX is specifically designed for incoming 6th, 7th, and 8th-grade students. At MIX, your students will experience high-energy worship, age-intentional Bible teaching, community with their friends and adult leaders, and a practical call to Kingdom Work, all centered around the fun and chaos that is middle school ministry. Please fill out the registration information and waiver for Westside. A $50 deposit is due at registration however you may opt to pay the full amount today ($100). If only deposit is paid, the balance is due May 10th. CIY MIX takes place June 10-13th.

Student Information

Student First name

Student Last Name

Grade

Gender

Male

Female

Shirt Size

Allergies/Medications/other info (Anything we need to be aware of)

Parent Information

First Name

Last Name

Email

Phone Number

Emergency Contact Information

Name of Emergency contact #1

Emergency contact #1 Relationship to Child

Emergency Contact #1 Phone Number

Name of Emergency Contact #2

Emergency Contact #2 Relationship to Child

Emergency Contact #2 Phone Number

Mandatory parent meeting

I understand there will be a mandatory parent meeting on Sunday, May 19th at 1:00 pm and I will do my best to attend.

Yes

No

Consent and Certification

Consent and Certification I, the undersigned, being the parent or legal guardian of the youth named above, do hereby consent to the participation of my youth in all the scheduled youth activities of Westside Christian Church, and any other supervised activities customarily associated with its youth group, including youth rallies and overnight or weekend youth trips. Further, I certify that my youth is physically fit and adequately prepared to participate in all recreational and sporting events. If I wish to revoke this consent for any reason, I will promptly notify the youth leader in writing. Medical Treatment Authorization I understand that I will be notified in the case of a medical emergency. However, in the event that I cannot be reached, I authorize the calling of a doctor and the providing of necessary medical services in the event that my youth is injured or becomes ill. My signature below indicates my consent.

Date Input

Signature

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Submit

Step 2: PAYMENT

You may place a deposit or pay for the event in full. Select the appropriate payment method below. Should you choose to pay the deposit, the balance will be due by May 10, 2024. You can return to this page to make final payment.

Step 3: FINAL PAYMENT

If you made a deposit at registration, you must return to this page and complete final payment by May 10, 2024. You WILL NOT complete Step 1 and 2 again, only Step 3.

Final payment ( only paid if deposit was made at registration)

PARENT INFORMATION

WHAT IS MIX?
MIX is specifically designed for incoming 6th, 7th, and 8th-grade students. At MIX, your students will experience high-energy worship, age-intentional Bible teaching, community with their friends and adult leaders, and a practical call to Kingdom Work, all centered around the fun and chaos that is middle school ministry.
WHO CAN ATTEND?
MIX is a preteen and teen conference for middle school students in 6th through 8th grade.

WHAT IS THE COST?
The cost of MIX is $100. This fee covers admission to the conference, and the food they will be eating through the 4 days. This cost, also, covers the expense of the trampoline park and food that the students will be partaking in during the fun day.

WHERE IS THE CONFERENCE?
MIX is held at Southeastern University in Lakeland, Florida. 1000 Longfellow Blvd, Lakeland, FL 33801. However, all drop-off and pick-up will take place at Westside Christian Church.

WHO WILL CHAPERONE THE EVENT?
Westside Christian Church has screened and trained student ministry volunteers and drivers who will chaperone this event. In fact, MIX requires that each church ministry group to be accompanied by volunteers who have undergone background checks, screening, and training. Because of our safety policy and the requirements set forth by MIX, we cannot allow non-approved parents or volunteers to travel with us or attend the event. Thank you for your understanding as we seek to provide the safest environment for your children.

WHAT ABOUT OVERNIGHT LODGING?
We will stay in the dorms of Southeastern University. Exact location of dorm will be determined at a later time.

HOW DO WE REGISTER: Deadline to register is May 10th, 2024 paid in full. Register by completing the form above by May 10th, 2024. If you have any questions at all please do not hesitate to contact Cameron at cameron@westsidechristianchurch.com or (765) 432-2943.