South Central IndianaGreat Banquet 550 South SR135, Morgantown, IN 46160 Guest Registration Form Guest Information First Name (preferred name) Last Name Street Address City State Zip Email Mobile Phone Birthdate Age Number of Children Church Affiliation (if any) Marital StatusSingleMarriedWidowedDivorcedSeparated Biological SexMaleFemale Banquet Weekend Which season are you registering for?Men's or Women's weekend is determined by the Biological Sex selected above.FallSpring Have you ever attended another 3-day weekend before? (e.g. Cursillo, Tres Dias, Walk to Emmaus, Awakening)YesNoIf yes, which weekend? Dietary & Health Dietary Needs / Food Allergies (needs, not preferences) Are you on any special medications?YesNoIf yes, please list: Any health concerns that may affect your attention to the weekend?YesNoIf yes, please describe: Any physical needs we should be aware of?YesNoIf yes, please describe: Emergency Contact Name Emergency Contact Phone Your Why Briefly, why do you wish to be involved in the Great Banquet, and what do you expect from it? Sponsor (This Section Must Be Completed) Sponsor's Name Sponsor's Phone Sponsor's Email Liability Release, Medical Authorization & Media Consent I understand that participation in a South Central Indiana Great Banquet weekend involves group travel, activities, and communal lodging that carry inherent risks. In consideration of being permitted to attend, I release South Central Indiana Great Banquet, its host venue, and its volunteer leadership team from liability for any injury, loss, or damage arising from my participation, except to the extent caused by gross negligence or willful misconduct. If I am unable to respond and cannot be reached in a timely manner during the weekend, I authorize the weekend's volunteer leadership team to arrange emergency medical care on my behalf, and I agree to be financially responsible for any treatment provided. I consent to being photographed or recorded during the weekend and to that material being used for South Central Indiana Great Banquet ministry purposes (newsletters, website, social media), unless I check the box below. I do NOT consent to the use of photos/video of me as described above.Yes, I opt out Signature (type your full name to sign) * Submit Registration Your submission goes directly to the SCI Great Banquet community records.
