ACS20: Annual Conference Registration

September 18-21, 2020

Double Tree Hotel
1150 9th Street
Modesto, CA 95354

Registration Deadline: September 1, 2020

If you need assistance with registration, please email Conference Registrar, at acsregistrar@calnevumc.org.

* indicates required field.

Contact Info:

The name entered here should be the name of the registrant. If you are filling this form out for another individual, make sure to enter their name. Ideally, the email should also be the registrant's email, but you may input your email if you are communicating on behalf of the registrant. A valid email is required to receive a confirmation notice and ticketing information.

*First Name
*Last Name
*Email
*Select your conference leadership status:
REGISTRANT INFORMATION

Names are sorted alphabetically by last name. If your name is misspelled, please contact the conference registrar to make corrections.

CLERGY
*My clergy status is:
Deacon in Full Connection:

(select your name from the list)

*Elder in Full Connection:

(select your name from the list)

Retired Elder:

(select your name from the list)

Retired Associate Member:

(select your name from the list)

Retired Deacon:

(select your name from the list)

Full-Time/Part-Time Local Pastor:

(select your name from the list)

Retired Local Pastor:

(select your name from the list)

Provisional Elder:

(select your name from the list)

Provisional Deacon:

(select your name from the list)

Elder Member of other Conference or Methodist Denomination:

(select your name from the list)

Retired Member of other Conference:

(select your name from the list)

Other Non-Methodist Denomination

(select your name from the list)

LAITY
*My laity status is:
*Lay Member to ACS:

(select your name from the list)

*Alternate Lay Member:

(select your name from the list)

Certified Lay Minister:

(select your name from the list)

*Certified Candidate for Ordained Ministry:

(select your name from the list)

*Date you became certified:
Supplied/Hired/Assigned

(select your name from the list)

Conference Officer:

(select your name from the list)

Conference Staff:

(select your name from the list)

*Lay Member by Virtue of Office:

(select your name from the list)

Enter first and last name:
Provisional Deacons

(Select your name from the list)

Deaconess:

(select your name from the list)

Diaconal Minister:

(select your name from the list)

PLEASE READ BEFORE CONTINUING.

This form is an application for consideration to be a member of the Youth Delegation to Annual Conference Session 2020.

To be considered for the Youth Delegation to the Annual Conference Session, you must:

  • be twelve (12) to seventeen (17) years of age; and
  • be a member of a local United Methodist Church in the California-Nevada Annual Conference; and
  • NOT be able to qualify or register under any other laity status (i.e. elected Lay Member to ACS by your local charge/church conference, Alternate Lay Member to ACS, etc.).

Other Qualifying Status. If you qualify or can register under any other laity status, please re-select the appropriate status. Most notably, Youth often may be elected as a Lay Member to ACS by the local church during its charge conference. If this is your case, please register under the Lay Member to ACS status. 

Additional Nominations and Elections. Youth who will be nominated and elected at their district conference sessions will be able to register after May 30.

Election Process. The process of nomination and election to serve as a voting or alternate member of the Youth Delegation is conducted by the district conferences in consultation with the Conference Committee on Young People's Ministry. If you are elected, you will be notified by email along with all necessary forms and housing information.

Accommodations. Housing for Youth Delegates will be covered by the Conference Committee on Young People’s Ministry.

_____________________________________________________________________________________________________________

PLEASE READ BEFORE CONTINUING.

This form is an application for consideration to be a member of the Young Adult Delegation to Annual Conference Session 2020.

To be considered for the Young Adult Delegation to the Annual Conference Session, you must:

  • be eighteen (18) to thirty (30) years of age; and
  • be a member of a local United Methodist Church in the California-Nevada Annual Conference; and
  • NOT be able to qualify or register under any other laity status (i.e. elected Lay Member to ACS by your local charge/church conference, Alternate Lay Member to ACS, etc.).

Other Qualifying Status. If you qualify or can register under any other laity status, please re-select the appropriate status. Most notably, Young Adults often may be elected as a Lay Member to ACS by the local church during its charge conference. If this is your case, please register under the Lay Member to ACS status. 

Additional Nominations and Elections. Young Adults who will be nominated and elected at their district conference sessions will be able to register after May 30.

Election Process. The process of nomination and election to serve as a voting or alternate member of the Young Adult Delegation is conducted by the district conferences in consultation with the Conference Committee on Young People's Ministry. If you are elected, you will be notified by email.

Accommodations. You will be responsible for your own accomodations. However, Young Adult Delegates will receive a stipend.

_____________________________________________________________________________________________________________

*First Name
*Last Name
*Address
City
*State
*Zip Code
*Preferred Phone Number

If you don't have a cell phone number, please indicate the best number where you can be reached.

*Email
Home Church

Churches are listed in alphabetical order by city name. If your church is not listed, please select N/A.

District

If you are not affiliated with a California-Nevada district, select 'N/A'.

If married, will your spouse be attending?
Yes
No
No answer
*Will your spouse be participating with voice and vote privileges or attending as an observer?
What is the name of your spouse?

Your spouse will receive an observer name badge. 

You cannot register your spouse. Your spouse must register individually if participating with voice and vote privileges. 

SPECIAL NEEDS
*Do you have special needs you want us to consider?
Yes
No
If yes, please explain.
*Do you have a disability (ie. visual, auditory, or physical) that requires special seating?

Members with disabilities who need special reserved seating are the only members who will have reserved seats.  For example, in front of the monitors or easy access for a wheelchair.  All others may choose their seats on arrival.

Yes
No
Indicate your seating preference:
DEMOGRAPHIC INFO
*Age (in September)
*Grade in Fall (2020)
*What is your current church?

For Clergy or lay appointed to serve a local church, this is the current church appointment. For retired clergy, this is your charge church. For Laity, this is your home church where you hold membership.

*Please indicate the age range that best describes you.
Youth (18 years or younger)
Young Adult (19-35 years)
Adult (36-64 years)
Older Adult (65 years or older)
If you are age 35 or younger, please enter your date of birth.
*Gender
Female
Male
Nonbinary
Preferred Pronouns (optional)
Racial Identity

Please select all that apply.

A - Asian
AA - African American/Black
H/L - Hispanic/Latina(o)
W - White
NA - Native American
PI - Pacific Islander
Other
If you selected other, please specify.
Ethnic Background

Please select all that apply.

Chinese
Filipino
Hmong
Japanese
Korean
Chamorro
Fijian
Samoan
Tongan
Other
If you selected other, please specify.
YOUTH AND CHILD PROGRAM (FEES APPLY)
*Do you have children that need to be registered for the Youth and Child Program?
Yes
No
PROGRAM INFORMATION

The deadline to register is September 1, 2020. Late registrations will not be accepted. 

Pricing Information:

Fees have been calculated to cover actual costs for a quality program, minus $3,500 subsidy from the Annual Conference. Fees include lunch, snacks, crafts, some field trips for kids and youth, and any extra staff required for the nursery.

FULL PAYMENT IS REQUIRED FOR SUCCESSFUL REGISTRATION OF YOUR YOUTH OR CHILD(REN).

Program Selections:

Choose all programs desired according to school grade in Fall 2020. Flexibility is extended based on the child’s needs.

6 months to 2 years old
Preschool to Kinder ( Ages 3-6)
Kids @ Conference (1st – 5th Grade)
Youth @ Conference ( 6th – 12th Grade)
PROGRAM TIME SLOTS FOR - 6 months to 2 years old
6 months to 2 years old - Friday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Friday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Friday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Saturday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Saturday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Saturday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Sunday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Sunday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Sunday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
6 months to 2 years old - Monday (8:15 am to 1:30 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
PROGRAM TIME SLOTS FOR - Preschool to Kinder ( Ages 3-6)
Preschool to Kinder ( Ages 3-6) - Friday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder ( Ages 3-6) - Friday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder ( Ages 3-6) - Friday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder (Ages 3-6) - Saturday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder (Ages 3-6) - Saturday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder (Ages 3-6) - Saturday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder (Ages 3-6) - Sunday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder (Ages 3-6) - Sunday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder (Ages 3-6) - Sunday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Preschool to Kinder (Ages 3-6) - Monday (8:15 am to 1:30 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
PROGRAM TIMES SLOTS FOR - Kids @ Conference (1st – 5th Grade)
Kids @ Conference (1st – 5th Grade) - Friday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Friday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Friday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Saturday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Saturday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Saturday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Sunday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Sunday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Sunday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Kids @ Conference (1st – 5th Grade) - Monday (8:15 am to 1:30 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
PROGRAM TIME SLOTS FOR - Youth @ Conference ( 6th – 12th Grade)
Youth @ Conference ( 6th – 12th Grade) - Friday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Friday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Friday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Saturday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Saturday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Saturday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Sunday (8:15 am to 1:15 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Sunday (1:15 pm to 5:45 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Sunday (7:00 pm to 9:30 pm) ($10)

Enter the number of children you are registering for this time.

Only number values are allowed
Youth @ Conference ( 6th – 12th Grade) - Monday (8:15 am to 1:30 pm) ($15)

Enter the number of children you are registering for this time.

Only number values are allowed
PARTICIPANT INFORMATION
*Participant Information

Copy and Paste the following into the blank field and fill in the appropriate information: (if multiple children, please separate with a blank space)

Full Name: 
Date of Birth:  
Age during Conference: 
School Grade (Fall 2020): 
Physician Name:
Physician's Phone Number:
Preferred Physician or Hospital during ACS:

Insurance Provider:
Insurance Plan Number:
Subscriber Number:
Please list any special needs:

 

HOTEL INFORMATION
Please provide information regarding your hotel (may be provided at check-in)

Copy and Paste the following into the blank field and fill in the appropriate information: 

Hotel: 
Hotel Room Number:
Hotel Phone Number:

PERMISSIONS
*Photo Release:

I give permission to allow photographs and/or video of my child/youth taken during the 2020 Annual Conference Session, September 18-21, 2020 to be used in conference publications, news releases, social media, online, and in other communications related to the mission of California-Nevada Annual Conference.

Yes
No
*Field Trip Permission:

I give permission for my child/youth to attend field trips and activities at the 2020 Annual Conference Session, September 18-21, 2020. I understand this includes permission for children and youth (grades 1-12) to ride in insured vehicles with insured drivers or on public transportation. 

Yes
No
*Medical Emergency Permission:

In case of emergency and in the event that I am not readily available, I/we give permission for the Annual Conference Childcare staff to obtain emergency medical treatment for my/our children.

Yes
No
*Parent/Guardian Signature:

Enter your name below. By typing your name and signing in the area below you are verifying your name and date of this signature

Draw your signature below.
clear signature
Questions/Concerns?

For all general questions or concerns, contact the conference registrar by email at acsregistrar@calnevumc.org.

For Youth and Young Adult Delegation, contact Shari Sandoval at yc@calnevumc.org.

For Youth and Child Program, contact Lisa Brown at lisa.brown@cnumc.org or 209-482-6260.

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