French Creek 75th Anniversary Celebration

Primary Contact

Full Name*

Cell*

Phone

Email*

Street Address*

City*

State*
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Zip Code*

Additional Family Members

How many total family members will be attending? *
1234567 or more

Names and age group of additional family members attending (Name / Age Group), if applicable

Age Groups:
Adults: 18+
Teens: 13-17
Youth: 4-12
Children: 3-

Additional Family:

Agreement and Signature

The words "execution," "signed," "signature," and words of like import in this Agreement or in any amendment or other modification hereof (including waivers and consents) shall be deemed to include electronic signatures or the keeping of records in electronic form, each of which shall be of the same legal effect, validity or enforceability as a manually executed signature or the use of a paper-based recordkeeping system, as the case may be, to the extent and as provided for in any applicable law, including the Federal Electronic Signatures in Global and National Commerce Act, the New York State Electronic Signatures and Records Act, or any other similar state laws based on the Uniform Electronic Transactions Act.

I agree to the publishing of photos of the conference, which may include my image, with the understanding that such photos will be used solely on the web site, social media, and/or in promotional materials. Photos will not include my name or any other personal information.

I agree to the disclosure of my personal contact information to French Creek Bible Conference Association staff members and the use of such information by staff members for purposes related to the conferences (e.g. letter writing). I also agree to the disclosure of my personal contact information to the Orthodox Presbyterian Church.

I agree that any claim or disputes I have or may have with FCBC Association or its staff will be settled by Biblical based mediation and, if necessary, legally binding arbitration in accordance to the provisions of article XII of the bylaws of FCBC Association.

Signature*

Date Signed*