OSYC 2022 Registration
OSYC 2022 will take place November 11th - 13th. Please contact Tania at 937-533-7982 or by email at kidmin@e1cog.com with any questions.
Student Information
Student Name
*
Phone
*
Current Grade
*
Please select one option.
7
8
9
10
11
12
Shirt Size (adult sizes)
*
Please select one option.
Small
Medium
Large
XL
2X
3X
Select Option
Small
Medium
Large
XL
2X
3X
Emergency Contact
Name
*
Address
*
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AA
AB
AE
AK
AL
AP
AR
AS
AZ
BC
CA
CO
CT
DC
DE
FL
FM
GA
GU
HI
IA
ID
IL
IN
KS
KY
LA
MA
MB
MD
ME
MH
MI
MN
MO
MP
MS
MT
NB
NC
ND
NE
NH
NJ
NL
NM
NS
NT
NU
NV
NY
OH
OK
ON
OR
PA
PE
PR
PW
QC
RI
SC
SD
SK
TN
TX
UT
VA
VI
VT
WA
WI
WV
WY
YT
Phone
*
Email
*
This address will receive a confirmation email
I am available to chaperone:
*
Please select one option.
Yes
No
Name(s) of Parents able to chaperone.
I'd like to pay the $80 deposit by:
*
Please select one option.
Using my student's account
Dropping off check/cash at the church office
Other (contact Pastor Jerry)
Parental Consent
By signing the esignature below, you are authorizing your student to attend the Ohio State Youth Convention. The registration amount of $80 is due by Oct. 1st. The remaining balance will be due by Nov. 1st.
Esignature
*
Submit
Description
OSYC 2022 will take place November 11th - 13th. Please contact Tania at 937-533-7982 or by email at kidmin@e1cog.com with any questions.
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