% Important%Information%for%The%Difference%2016%

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2 WhatisTheDifference? The$Difference$is$a$unique$Student$Ministry$event$in$which$several$youth$ groups$in$the$nacogdoches$area$come$together$at$pineywoods$camp$(near$ Corrigan)$to$study$the$truth$and$worship$with$one$another.$$Our$goal$is$that$ students$would$leave$having$grown$closer$to$christ,$having$grown$closer$to$ each$other,$and$ready$to$impact$our$city$for$the$cause$of$christ!$ ImportantInformationforTheDifference2016! Meet$in$the$Grace$Bible$Church$parking$lot$at$5:45pm$to$leave$on$ Friday,$January$29! We$will$not$eat$dinner$at$camp$on$Friday,$so$please$eat$before$you$ come$and$bring$snacks$if$you$know$you$will$be$hungry$friday$night! Bring$money$to$pay$for$fast$food$lunch$on$the$way$home! You$may$also$bring$money$to$use$for$the$vending$machines,$camp$ store,$or$to$buy$band$merchandise$(optional)! Pack$appropriately$for$the$weather! Students$may$have$cell$phones$on$the$ride$there$and$back,$but$no$ cell$phone$use$while$at$the$camp! on$sunday,$january$31! Please$have$forms$(registration$form,$Medical$Release,$GBC$Waiver)$ and$money$($90;$checks$made$out$to$grace$bible$church)$turned$in$ by$sunday,$january$24$at$the$latest! Questions/concerns contact$student$pastor$danny$combs$ Phone:$ ! PARENTS:$We$will$need$help$transporting$kids$to$and$from$the$ retreat.$$it$is$about$an$hour$drive$to$the$camp.$$please$contact$me$if$ you$are$willing$to$drive$and$let$me$know$how$many$kids$you$could$ take.$$thank$you!

3 The Difference Retreat is happening for our students grades 6-12! The dates are Friday, Jan. 29th - Sunday, Jan. 31st, at Pineywoods Baptist Encampment in Woodlake, TX. The cost for the retreat is $90, which includes all meals, t- shirt, transportation, worship, etc.. Please make sure that you fill out a registration form, Medical Release Form, and GBC Waiver. Forms are due back by Sunday, January 24th. If you have any questions, feel free to contact Danny at (936) or danny@gracebiblechurch.com. Thanks and have a blessed day! the difference 2016 What to Bring: - Bible - Pen - Paper - Athletic Wear - Bedding (Twin Size or Sleeping Bag) - Pillow - Towels - Shoes - Toiletries - A Friend - A Good Attitude What Not to Bring: - If it s questionable, don t bring it - If it s bad for you, don t bring it - If it can cause harm to yourself or others, don t bring it the difference 2016 registration form (Please fill out entirely) Name: Address: City: ST: Grade: Shirt Size: Gender: M or F Zip: Phone: Parent Name(s): Parent Phone:

4 Student Medical Release Form/Permission to Treat Student Name: Date of Birth: Address: City: State: Zip: Church/Group Name: Grace Bible Church Event: The Difference 2016 Family Physician: Phone: Address: Insurance Information: Insurance Company: Policy number: Group Number: Cardholder: Relationship to Cardholder: Insurance Company Phone: Emergency Contact Information: Parent/Guardian: Home Phone: Work Phone: Secondary Contact: Relationship: Home Phone: Work Phone: Please list any current Medical Diagnosis, allergies, prescriptions/dosages, and other relevant medical information: Parent or Guardian Authorization: In case of emergency, if family physician cannot be reached, I hereby authorize my child to be treated by Certified Emergency Personnel. (i.e. EMT, First Responder, E.R. Physician) Authorized Parent/Guardian Signature

5 GRACE BIBLE CHURCH WAIVER AND RELEASE OF LIABILITY This Waiver and Release of Liability ( Waiver ) is entered into on the 29 day of January 2016, by and between Grace Bible Church (the church ) and (the Participant ) desires to participate in The Difference 2016 (church sponsored event). In consideration of being permitted to participate in the Activity, Participant agrees as follows: I release, waive all claims against, discharge and covenant not to sue the church, event property owners, or any of the church s elders and employees, including but not limited to pastors, staff and other employees, members, representatives, or volunteers (collectively referred to herein as church representatives ) with respect to my participation, including without limitation attendance at, observation of, or being otherwise involved in the activity ( participation ), whether my claim or the claim of anyone on my behalf is based on or arises out of personal injury, death or injury to property and whether such claim is caused by the negligence of the church or any of the church representatives. I assume full responsibility for and risk of bodily injury, death or property damage due to the negligence of the church or any of the church representatives with respect to my participation in the activity. I agree to indemnify and hold the Church harmless from the claims of any third party arising as a result of my participation in the Activity. I have read this waiver in its entirety and I understand that by signing this waiver I am releasing all future claims I may have against the church and any church representatives with respect to my participation in the activity. Parent/Guardian Signature: Participant Name (please print):