REV WKND 2025 STUDENT REGISTRATION

MARIETTA FIRST - M1 STUDENTS

Upon submitting this registration form, you will be directed to the payment or click the following link: PAY HERE.

Student Information

First Name

Last Name

Phone Number

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Gender

Male

Female

Current Grade

Birthdate

School

T-Shirt Size (Adult Sizes Listed First)

Medium

2X

*The shirts are long sleeve tees this year. They are a little on the large side, so you may want to order a size down.

Parent Information

PARENT/GUARDIAN 1 (First Contact)

First Name

Last Name

Phone Number

PARENT/GUARDIAN 2 (Second Contact)

First Name

Last Name

Phone Number

Medical Information

Allergies/Medications

Medications

Insurance

Payment Information

The registration fee for REV WKND is $50. This includes all meals, a t-shirt and all other expenses to make this event possible. Use the code SIBLINGS when paying for additional siblings and the discount code SCHOLARSHIP if applying for a partial scholarship.

Payment Options

I am paying the total $50 fee via credit/debit card online (Use the discount code SIBLING to pay $30 separate for each additional sibling).

I am paying the total $50 fee by cash or check at the church.

I am applying for a PARTIAL scholarship. With a partial scholarship, I understand I would only pay $20 (Use the discount code SCHOLARSHIP to pay the discounted $20 partial scholarship fee).

I absolutely cannot pay anything and need to apply for a FULL scholarship.

Scholarship Application (Financial Assistance)

Online Credit Card Payment:
You will have to pay separate for each extra sibling and use the following discount code: SIBLING. If you are applying for a partial scholarship, use the following discount code: SCHOLARSHIP.

Parent/Guardian Consent:
By digitally signing below, I acknowledge that I am agreeing to all aforementioned requirements for my child to attend REV WKND 2025 with Marietta First Baptist Church. I acknowledge that my student is participating voluntarily in the activities and the program at their own risk, and I expressly accept full responsibility for all of the risks, known or unknown. I elect to allow my student to participate in spite of the risks, known or unknown. I agree, therefore, that Marietta First Baptist Church and the home my child will be staying in will not be liable to me for any injuries to my child or to my property, which may occur as a result of my participation in REV WKND 2025.

Signature