2016 South Texas Teen Bible Quiz Camp/Seminar 1st A/G LaPorte, 316 E Fairmont Pkwy, LaPorte, TX 77571 Registration deadline: August 24, 2016 (Space is limited – any registration received after all openings have been filled will be returned)

Church: ______District: ______

Quizzer or Leader’s Name: ______# Years In Quiz: ______

Church Quiz Coach or Coordinator’s Information:

______Name Cell # Email

Quizzer: What league will you participate in during the 2016/2017 Quiz Season: A League Middle School Experience/B League Leader: What position will you be serving in during the 2016/2017 Quiz Season: Coach Official Helper 2016 South Texas TBQ Camp Permission Form All quizzers should memorize/study Galatians 3. Quizzers w/ experience also should memorize/study Galatians 1 & 2.

(for those under the age of 18) I give permission for my child to participate in the South Texas TBQ Camp that will be held at LaPorte First A/G Church on August 27, 2016. I understand the arrangements and feel that adequate precautions for the safety of my child have been, and will continue to be taken. The District Councils of the Assemblies of God in the South Texas will not be held liable for illness, injury, or loss of life while the above child is participating in this event.

Name of Young Person: ______Date of birth:______

Is your child being treated for an injury/sickness or taking any medication? Yes / No If Yes, explain:______Does your child have any Allergies/Disabilities? Yes / No If Yes, explain:______Does your child medically require a special diet? Yes / No If Yes, explain:______

I give permission for my son/daughter to attend.

______Parent/Guardian Signature Printed Name Date Please complete this registration form and mail it along with your registration fee to: Fowler, 12707 Fisher Dr., Baytown, TX 77523 or email to [email protected] Make checks out to South Texas YM - put TBQ camp in memo Registration Fee: Quizzer - $10 / Leader - $10