2027 ELCA Youth Gathering (Youth and Leader Registration)

Minneapolis, MN
June 28th - Aug 2nd
Current 9th-12th Graders
Cost: Total $200 ($50 down payment)

Thank you for filling out our 2027 ELCA Youth Gathering registration form. Watch for more info and pre-trip meeting dates in the new year!

*Youth who volunteer at an FLC event/fundraiser are able to receive $25 off each time they volunteer.

*Adult Leader Cost; Down Payment ONLY

Questions? Contact Olivia YFM Dir at olivia@firstlutheranchurch.com

Youth or Adult Leader Name

Youth or Adult Leader Preferred Name

Youth or Adult Leader Email (if applicable)

Youth or Adult Leader Phone

Address

Current Grade

9th 10th 11th 12th Adult Leader/Chaperone

T-Shirt Size

Small Medium Large X Large XX Large 3XL 4XL

Gender Identity

Female Male Gender Non-conforming

Racial and/or Ethnic Identity

African Descent or Black America Indian or Alaska Native Asian or Pacific Islander Latino/a Arab or Middle Eastern European American or White Multiracial / Multiethnic

Parents/Guardians Info and Emergency Contacts

Parent/Guardian #1 Name

Parent/Guardian #1 Phone

Parent/Guardian #1 Email

Parent/Guardian #2 Name

Parent/Guardian #2 Phone

Parent/Guardian #2 Email

Emergency Contact Name

Emergency Contact Phone

Emergency Contact Relationship to Youth

Accommodations

Communication and Language Access This person requires Spanish language translation services. This person requires American Sign Language (ASL) interpretation. This person requires assistive listening devices. This person requires other translation or communication support (please specify).

Mobility & Physical Access This person uses a wheelchair full-time. This person uses a wheelchair or mobility aid part-time (cane, walker, crutches). This person cannot stand or walk for extended periods. This person requires accessible seating. This person requires an ADA hotel room. This person will be attending with a Personal Care Assistant (PCA) or service animal.

This person will be attending with a Personal Care Assistant (PCA) or service animal. If checked, what service does the animal provide?

Visual Access This person needs braille resources. This person needs resources provided electronically in .txt or .rtf. This person needs resources in large print. This person needs a guide/companion for navigation.

Sensory & Neurodivergent Access This person has sensory sensitivity to light. This person has sensory sensitivity to sound. This person benefi ts from access to low-stimulus or quiet spaces. This person benefi ts from advance communication about schedules, crowds, or transitions.

Health & Medical Considerations This person has severe allergies (food, environmental, or other). This person needs access to a refrigerated medication storage. This person is medically prohibited from prolonged exposure to sun or heat. This person is medically prohibited from handling certain food products. This person is medically prohibited from being around animal allergens. This person is medically prohibited from walking long distances. This person is medically prohibited from dusty or poor-air-quality environments.

Do you have any dietary requirements we should accommodate? Vegetarian Vegan Gluten-free Nut-free Egg-free Dairy-free Soy-free

Other Needs or Considerations

Trip Participant Agreement, Permission, and Health Form

Please fill out and return to Olivia YFM Dir.
olivia@firstlutheranchurch.com

YOUTH FORM

ADULT LEADER FORM

Adult Leaders/Chaperones ONLY

Are you a(n):

ELCA Rostered Minister of Word and Sacrament ELCA Rostered Minister of Word and Service Paid Congregation Employee (non-rostered) Volunteer Leader/Chaperone

Cost ($50 Down Payment; $150 due in April)

Down Payment

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

2027 ELCA Youth Gathering (Youth and Leader Registration)

Description

Please Fix the Following