July 12th - 15th, 2023

Deadline: June 26, 2023

Fill out the form below to
REGISTER

Name *

First

Last

Registration Type *

Student - $40
Counselor - $25
Volunteer

Email *

Phone Number

Do you have a cell phone with data/wifi capabilities?

Address *

Address 2

City

State/Province

Zip/Postal Code

Country

Gender

Birthday

School Grade Going Into Fall 2023

T-Shirt Size

Home Church

If Applicable

How did you hear about JesusWalk this year? *

Name of Parent/Guardian

First

Last

Parent Email

Write N/A if not applicable

Phone Number

Home Address

If different from above

Home Address guardian

City

State/Province

Zip/Postal Code

Country

Relationship to student

Agreement to participate *

I Agree

LIABILITY
By signing below, I agree that I, the participant, acknowledge that the JesusWalk Youth Organization is not liable for any and all losses, claims, damages to property, damages to electronic equipment, injuries, liabilities and additional expenses incurred. I agree to abide by the guidelines set by the JesusWalk Youth Conference staff regarding online and in-person safety and behavior.

CONFIDENTIALITY
The counselors and staff at the JesusWalk Youth Organization are bound by confidentiality. Discussions between a student and a counselor will remain confidential. Information will not be revealed without permission from the person who has provided the information. The only time confidentiality may be broken is if a student discloses any form of abuse, harm to one-self, or harm others. The JesusWalk Youth Organization reserves the right to follow the mandated reporting protocol for the safety of the student.

ONLINE RULES
JesusWalk students are expected to be considerate, respectful and courteous to the JesusWalk staff, volunteers, and fellow peers. Students agree to respect the online platforms and chat features provided by the JesusWalk Youth Organization. Students must be mindful of the Christian youth conference online environment and must keep all digital mediums PG appropriate for children and families. If students are unable to follow these guidelines, they will be subject to consequences at the discretion of the JesusWalk Youth Organization. I agree to abide by the guidelines set by the JesusWalk Youth Organization staff regarding online safety and behavior.

MULTIMEDIA
I grant permission to JesusWalk Youth Organization to reproduce photographs and videos taken of me for the purpose of publication or illustration for JesusWalk Youth Organization’s mission.

IN-PERSON RULES
JesusWalk students are expected to be considerate of facilities on site and be courteous to the JesusWalk staff, volunteers, and fellow peers. As per the guidelines from the Center for Disease Control and the Orange County Department of Public Health, all staff and participants are expected to follow the suggested protocols to meet safely outdoors. This includes, but not limited to, physical (social) distancing, use of masks, and hand hygiene. Lastly, if you feel sick or ill with any symptoms, please stay safe at home.

By checking the box below you agree to all the terms above.