Penn West Youth National Youth Event Pre-Registration Form (Chaperone)
ALL STATE REQUIRED CLEARANCES TO ATTEND, NO EXCEPTIONS
As we begin to prepare for the upcoming National Youth Event in Walt Disney World on July 26-30, 2016, we need to start gathering information about those planning to attend.  Please note that this is NOT your official NYE registration! This form is only for the purpose of PWC planning.  When NYE registration opens, we may require more information, as well as the registration payment of $549 to complete the registration process.   IMPORTANT...THE PWC GROUP DEADLINE IS JANUARY 15TH, 2016!
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Name *
Do you currently have PA State Volunteer Clearances? *
Current clearances have been obtained within the last 12 months.
Street Address *
City, State and Zip *
Preferred Phone Number *
Are you able to receive text messages via your preferred phone number. *
Email Address *
Social Media Use *
Home Church *
Pastor's Name
PWC Association *
Do you want to be included in the PWC group travel plans. *
At this time, we plan to fly Southwest Airlines out of Pittsburgh PA.  We cannot finalize these plans until we have an official number of those attending.
I am willing to serve as a chaperone for youth that are not members of my congregation? *
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