Download the FAQs for the 2022 COREM Convocation

Please be aware our venue requires that participants must be vaccinated if eligible.

Please be aware that participants must be vaccinated if eligible, and proof of vaccination (vaccination card), as well as a photo ID, will need to be presented upon check-in at the venue.

A photo ID for youth under 18 is not required, but proof of vaccination must be presented.

No one will be admitted to the convocation without having these protocols in place and no refunds will be issued.

Download the FAQs

Name*

First Last

Home Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Ministry selection

PAAM

CAIM

MRSEJ

COLECTIVO

UBC

USM

Registrant's Email Address*

Or parent's email address if the registrant is under 18.

Registrant Cell Number*

Or parent's cell number if the registrant is under 18.

Are you registering as a*

Youth - Full Time or Part Time

Youth Full Time - Arrive 6/23, Double Occupancy

Youth Part Time - Arrive 6/24, Double Occupancy

Adult - Day of Arrival*

Adult - Single or Double Occupancy*

Single

Double

Adult - Preferred roommate?

Roommate preference not guaranteed.

Adult - Will you have children under age 12 with you?*

Children ages 6 to 12 must be accompanied by a parent or guardian. There is no childcare available for younger than 12).

Yes

Adult - How many children are you bringing?

Child #1 Name

First Last

Child #2 Name

First Last

Child #3 Name

First Last

Child #4 Name

First Last

Registration Youth 13-17 - Preferred roommate?*

Roommate preference not guaranteed.

Registration Youth 13-17 - Email Address

Registration Youth - Phone Number*

Name of Parent/Guardian #1 if you're under 18*

First Last

Parent #1 Home Address*

Street Address Address Line 2 City State ZIP Code

Primary Phone Number: Parent #1*

Additional Phone Number: Parent #1

Email Address of Parent/Guardian #1 if you're under 18*

Name of Parents/Guardian #2 if you're under 18

First Last

Primary Phone Number: Parent #2

Additional Phone Number: Parent #2

Email Address of Parent/Guardian #2 if you're under 18

Home Church and City

Example: Berkeley Chinese Community Church, Berkeley, CA

PAAM Region

Are you a delegate from a PAAM region?*

Are you Clergy or Lay?*

Do you have any mobility issues?

Gender

Please check whether you can volunteer in any other he following area:

You will be contacted by the appropriate committee.

Participate in convocation choir

Help with worship services

Assist a registration table

Other

Other areas you'd like to volunteer in

Do you have any allergies?*

Yes

Please list food and other allergies below.*

Adult registration - Arrive 6/23, Single Occupancy

Arrive by midnight 6/23, (Check-in 6/23/22 3pm, check out on 6/26/22 10am)

Price:

Adult Registration - Arrive 6/23, Double Occupancy

Arrive by midnight 6/23, (Check-in 6/23/22 3pm, check out on 6/26/22 10am)

Price:

Adult Registration - Arrive 6/24, Single Occupancy

Arrive after 8am 6/24 , (Check-in 6/24/22 3pm, check out on 6/26/22 10am) 

Price:

Adult Registration - Arrive 6/24, Double Occupancy

Arrive after 8am 6/24, (Check-in 6/24/22 3pm, check out on 6/26/22 10am) 

Price:

Adult Registration - Arrive 6/24, Day Visitor

Arrive 6/24, day visitor, no lodging, meals purchased on site

Price:

Registration Youth Full Time - Arrive 6/23, Double Occupancy

Arrive by midnight 6/23, (Check-in 6/23/22 3pm, check out on 6/26/22 10am)

Price:

Registration Youth Part Time - Arrive 6/24, Double Occupancy

Arrive by midnight 6/24, (Check-in 6/24/22, check out on 6/26/22 10am)

Price:

COREM Convocation Spirit Wear

Pre-order only. Will not be sold at the Convocation.

Shirts will be available for pick-up when you check in at registration.

Small t-shirt

Price: $18.00

Medium t-shirt

Price: $18.00

Large t-shirt

Price: $18.00

XL t-shirt

Price: $18.00

2XL t-shirt

Price: $20.00

3XL t-shirt

Price: $20.00

4XL t-shirt

Price: $25.00

Youth Code of Conduct

I agree to uphold and exemplify positive Christian values, and I understand that my participation in this event requires compliance with rules and regulations regarding my conduct. Specifically, I agree that during my participation in the event:

I will follow the directions of adult leaders
I will treat adult leaders and other participants with respect
I will stay with my assigned group, and participate in the approved activity
I will dress appropriately at all times
I will not use, bring, or be under the influence of illegal drugs or alcohol
I will not smoke or use tobacco products
I will not engage in inappropriate sexual behavior
I will not be in the possession of or use firearms, knives, or weapons of any kind
I will not engage in acts of violence, stealing, dishonesty, gambling, or profanity
I will respect the physical property of the facility and of others, and will not engage in acts of vandalism.

I agree to abide by these rules and the supervision of adult leaders and understand that violations will be dealt with in an immediate and appropriate manner. If I should be dismissed from participation in the event, I understand that my parents will be contacted to arrange for my immediate transportation home.

Signature of Youth Participant*

Date

Signature of Parent/Guardian Acknowledging the Commitment*

Date

Emergency Health / Medical Information and Consent

In the event of an emergency, I, the undersigned parent/guardian of the child named on this form, hereby give permission to COREM and their employees, agents, representatives, and adult volunteers, to arrange for and authorize emergency medical, dental, or surgical treatment for my child, as considered necessary by the attending physician. I wish to be advised prior to any further treatment by the hospital or doctor.

Family Doctor*

Phone*

Family Dentist*

Phone*

Family Health Plan Carrier*

Policy Number*

Emergency Contact Information

I also agree to provide COREM with current telephone numbers at which I can be reached, as well as the names and phone numbers of individuals who are likely to know where I am should an emergency arise. In the event of an emergency, if you are unable to reach me please contact:

Emergency Contact Name*

First Last

Relationship*

Phone*

Alternate Contact Phone*

Signature of Parent/Guardian*

Date

Medications and Non-Emergency Health Treatment

(Please sign/authorize all of the following authorizations/directions that are applicable.)
1. If my child becomes ill with symptoms that do not indicate emergency medical treatment (e.g., headache, vomiting, sore throat, fever, diarrhea), I wish to be called (collect/reversed phone charges if necessary) to be informed of my child’s condition.

Signature of Parent/Guardian*

Date

2. My child is currently taking the following medication(s), which he/she will bring on this activity, in well labeled, original containers that include clear directions for dosage and frequency of use. I hereby give permission for an adult leader to administer the following medication(s):

List medications*

Signature of Parent/Guardian*

Date

3. No medication of any type (prescription or nonprescription) may be administered to my child unless his/her condition is life-threatening and emergency treatment is required, as considered necessary by the attending physician.

Signature of Parent/Guardian*

Date

4. I hereby grant permission for nonprescription medication (e.g., non-aspirin pain relievers, throat lozenges, cough syrup) to be given to my child, if deemed advisable by the adult supervisor of the activity, subject to the following exceptions (write “none” if there are no specific exceptions):

List non-prescription medications

Signature of Parent/Guardian*

Date

Specific Medical Information/Conditions

Allergic reactions (to medications, foods, plants, insects, etc.) Please list below.

Immunizations (date of last tetanus/diphtheria immunization) Please list below.

Current medications being taken by child. Please list below.

Medically-prescribed dietary restrictions? Please list below.

Physical limitations? Please list below

Any recent exposure (within the past four weeks) to contagious disease/condition, such as mumps, measles, chicken pox? If so, specify the date and the condition exposed to below.

Any dietary restrictions (other than allergies identified above)? Please list below.

Any other special medical issues or other conditions to be aware of? Please list below.

Parent Agreement/Consent

I/we, the undersigned parent or guardian of the child named on this form give permission for my/our child’s participation in the activity referred to on this form, and in addition to the Health/Medical Information Consent provisions that we have agreed to above:

Direct Child to Cooperate: I/we agree to direct my/our child to cooperate and comply with all reasonable directions and instructions from COREM staff or adult volunteer leaders.
Consent for Transportation (if applicable): I/we give permission for my/our child to be transported to and/or from the specified programs, events, and activities in vehicles driven by adult leaders selected by COREM
Responsibility for Medical Expenses: I/we agree to be responsible for all medical expenses relating to injury of my/our child as a result of his/her participation in this activity, whether or not caused by the negligence of COREM, agents, volunteers or other participants.
Acknowledgment of Risks: I/we understand that in the course of participating in this activity, my/our child may engage in activity that carries a risk of injury to the body, psyche, or property of themselves and others. Such injuries can be caused by other persons, may be accidental or self-inflicted, or may arise from faulty equipment or facilities, existing conditions of recreational facilities, vehicle accidents while in transport during an activity, or through the activity itself.

Accordingly, in consideration for being permitted to participate in the specified activities, to use the equipment provided, and to enter the premises and facilities of Sonoma State University, for any purpose including observation of and participation in activities, the undersigned parent or guardian, for him or herself and any successors in interest, and on behalf of the minor child, agrees as follows:

To release, waive, discharge, and promise not to sue the Council Of Racial & Ethnic Ministries, and its affiliated entities, employees, agents, and volunteers from all liability for any loss or damage, and any claim or demands therefore on account of injury to the body, injury to the psyche, or injury to the property of the minor child, or to undersigned parent or guardian, whether caused by negligence or other conduct by the Council Of Racial & Ethnic Ministries while the minor child is participating in the specified activities or in, upon, or about the premises of Sonoma State University or any of its facilities or equipment.
To indemnify and hold harmless the Council Of Racial & Ethnic Ministries from any loss, liability, damage, or cost it may incur due to the acts of the minor child in, upon, or about the premises of Sonoma State University, its facilities or equipment, or while participating in any activities whether caused by negligence or otherwise.
That he or she has read this Consent Form and agreement and voluntarily signs it, and that no oral representations, statements, or inducements apart from the contents of this form have been made. I/we have read this Agreement and understand and agree to everything set forth above.

Signature of Parent/Guardian*

Date

Total

Billing Zip Code*

ZIP Code

Credit Card

Card Details

Cardholder Name

2022 COREM Convocation Form

Please be aware our venue requires that participants must be vaccinated if eligible.

COREM Convocation Spirit Wear

Youth Code of Conduct

Emergency Health / Medical Information and Consent

Emergency Contact Information

Medications and Non-Emergency Health Treatment

Specific Medical Information/Conditions

Parent Agreement/Consent

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