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I agree to the code of conduct.
As a participant in an activity at Kentucky Christian University, you are expected to observe the following Code of Conduct:
- As a participant in an activity at Kentucky Christian University, you are expected to observe the following Code of Conduct:
- All participants are expected to maintain a positive attitude during the week as unity and cooperation are key elements in making each week a success.
- All participants are expected to respect and obey event staff personnel and adult group sponsors.
- All participants are expected to attend and not be late to all main sessions.
- Breakfast is optional. Event staff will not be waking you up so you should bring an alarm clock.
- All participants are expected to respect others in the dorms. Lights out is mandatory and attendees are expected to be in their rooms and quiet at this time.
- All participants are expected to dress appropriately for a Christian function. Messages displayed on clothing that are opposed to the standards of Kentucky Christian University are not allowed. (i.e. beer advertisements, profanity, etc.)
- The use of illegal drugs, alcohol, perverse/profane language is strictly forbidden.The campus of Kentucky Christian University is designated as a smoke-free environment. The use of tobacco products is prohibited.
- 网赌最好最大平台 is a weapons free campus and all firearms, fireworks, water cannons, water guns and water balloons are prohibited.
- The following areas are designated as off limits to all participants:
> The cemetery behind Dale Hall
> Kentucky Christian University Apartments
> Chapel House and Friendship House
> Dorms of the opposite sex
- All participants are expected to observe common courtesy (picking up trash, litter, and cleaning up after themselves).
- Public display of affection between couples is not permitted.
- If property damage occurs, you may be charged a minimum of $50 plus materials and labor to repair such damage.
Adult Leader Signature
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Date
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MM slash DD slash YYYY
Health/Medical Information
Do you have ailments, diseases, allergies or restrictions?
Do you have any mental health diagnosis?
List Operations/Serious Injuries (with dates)
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MM slash DD slash YYYY
Name of Primary Physician
(Required)
Prefix
Dr.
Miss
Mr.
Mrs.
Ms.
Mx.
Prof.
Rev.
First
Last
Physician City/State
City
State / Province / Region
Physician's Phone Number
Health Information
(Required)
I agree
The health history is correct so far as I know, and the person herein described has permission to engage in all prescribed event activities except as noted.
Parent/Guardian Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
Complete Name of Insurance Company
Policy Holder Name
Group #
Policy #
Group Name
Address of Insurance Company
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Country
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Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
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Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Name of Emergency Contact
First
Last
Emergency Contact Phone Number
Permission
(Required)
I agree
I authorize Kentucky Christian University and its employees or agents to take photographs, video recordings, and audio recordings of me and/or my child. I agree to my image, voice and/or likeness being used in all forms of print and electronic media publications and/or video productions for purposes related to the University, including research, education, publicity, marketing, and promotion of programs for the University. I agree to hereby release, hold harmless, and discharge 网赌最好最大平台, its offers, agents, and employees from and against any and all claims, actions, or causes of action, liability, and demands whatsoever beyond the control of, and without the fault or negligence of Kentucky Christian University.
Adult Leader Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
Background Check
(Required)
I agree
The safety and security of the students and leaders in your ministry is very important to 网赌最好最大平台 and the SITS program. 网赌最好最大平台 is unable to verify the background of every leader that comes to a summer conference. 网赌最好最大平台 mandates that you take the safety of your group as well as that of other groups attending this event very seriously.
网赌最好最大平台 requires that you run a National Criminal and Sex Offender Background Check on every adult leader working with students. 网赌最好最大平台 will NOT reimburse for these background checks.
I verify that the above information is accurate. I understand that adults who have a record cannot attend Summer In The Son at Kentucky Christian University and that 网赌最好最大平台 reserves the right to remove from this event any person that in its sole opinion poses a threat to those in attendance. I agree to adhere to the requirements set by 网赌最好最大平台.
Can you verify that you have had a National Criminal and Sex Offender Background Check in the past year by the church/group you are attending the event with?
(Required)
Yes
No
***If you answered no to Question #1 above, please note that background checks are MANDATORY for each adult leader attending SITS and are REQUIRED to be completed for the event.
Can you verify that you, as an adult leader accompanying students, have not had arrests or convictions of any kind on your background check?
(Required)
Yes
No
*** If you answered No to the question above, please explain below:
Adult Leader Signature
(Required)
Date
(Required)
MM slash DD slash YYYY
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