2 Training * Ranger Basics * Ranger Essentials * 1st/CPR and Safety * Workshops * Archery Cert & Instructor * Black Powder Safety * Exhibits, Auction, Fellowship * NRA Shotgun Safety * Kids Events & Nursery (only if pre-registered) SPOKANE VALLEY, WA April 6-7, 2018 For Registration and More Information see: www.nwrroyalrangers.org
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For Registration and More Information see: …...* Archery Cert & Instructor * Black Powder Safety * Exhibits, Auction, Fellowship * NRA Shotgun Safety * Kids Events & Nursery (only
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District: Outpost #: Chartered? Yes or No (Circle one)
Archery / Black Powder / Shot Gun / 1st Aid & CPR with Safety / Ranger Basics / Ranger Essen als / Junior Academy
(Circle One Choice for your Friday Class so we can properly prepare materials)
Are you bringing your kids with you? Yes or No (Circle one) If yes, please provide the following informa on: (indicate Y or N if your child needs nursery)
Name Grade Gender Nursery? Friday Saturday
Name Grade Gender Nursery? Friday Saturday
(use a second form if you have more than 2 children a ending with you)
PRE‐REGISTRATION DEADLINE: March 15, 2018
Send registra on forms to Terry Campbell at 701 30th Street South, Great Falls, MT 59405
Stephen Hackler, Deputy Coordinator David Alexieff, Montana
Terry Campbell, Communica ons Coordinator Shawn Backus, Northwest
Larry Norris, FCF Territorial Rep Brad Phillips, Oregon
Danny Kolander, Training Coordinator Bruce Murphy, S. Idaho
Dean Kimber, Missions Brian Rossignol, Wyoming
Juan Baez, NW Hispanic
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MEALS: The following meals will be provided as part of your conference registra on:
REGIONAL AUCTION: There will be an original piece of artwork by Royal Rangers
leader & ar st, Fred Deaver; as well as a variety of other interes ng pieces for auc on.
Please plan on bringing an item to donate and consider purchasing items to benefit the
NW Royal Rangers ministry and missions. You can contact Terry Campbell at 406‐788‐1121
with items that you would like to donate for the auc on so we can get them posted on the
region’s website.
IITSWO Con nued
DAY/MEAL Breakfast Lunch Dinner
Friday Con nental
Breakfast
Sandwich board
and soup
Mexican Night:
Street tacos, beans,
rice, chips, salsa
and more!!!
Saturday Con nental
Breakfast
Sandwich board
and soup
N/A
Dessert
Cake &
Coffee
N/A
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2018 Northwest Region Leaders Conference Permission Slip, Medical Release, and Model Release Form for children
Name: Date of Birth:
Father's Name: Daytime Phone:
Mother's Name: Daytime Phone:
Address: City: Zip:
Church Name: Outpost #:
Church City/State: District:
Name of Adult you are attending Conference with:
Adult’s Phone Number (cell preferred):
Activities Consents I am the parent or guardian of the above-named minor who is attending the 2018 Northwest Region Royal Rangers Leaders Confer-ence in Spokane Valley, WA on April 6-7, 2018. I understand that my child’s activities at the Conference or off-site may include (but are not limited to) dodge ball, archery, shotgun, black powder shooting, BB gun, bowling, laser tag, Conferences, workshops, and more. Unless otherwise noted on this form, my child has permission to take part in any and all sanctioned activities of the Conference for the Jr. Leaders. This includes, but is not limited to transportation to and from activities, as well as participation in the activities. I will hold harmless the Northwest Region Royal Rangers, the National Royal Rangers Ministry, the General Council of the Assemblies of God, Spokane Valley Assembly of God, and any and all leaders/adults responsible for these activities for any un-foreseen accidents or injuries. Please list all activities that you do NOT consent to in the space below:
Model Release I hereby grant to the Northwest Region Royal Rangers the right and permission to copyright and/or use, reuse, publish and/or re-publish photographic or video images or pictures of my child taken during any sanctioned event of the Northwest Region Royal Rangers for advertising and/or promotional purposes. I hereby release, discharge, and agree to hold harmless the Northwest Re-gion Royal Rangers from any liability resulting from use of the above-mentioned photography, videos, or use of my child’s name. I understand that I will have no control over the manner of use of materials produced and hereby waive any right to preapprove or inspect materials prior to distribution.
Medical Authorization and Consents
I, _ _ , from , , the parent/guardian
(Parent or guardian’s name) (City) (State)
of ______ ____ , a minor who is attending the 2018 NW Regional Leaders
(Child’s Name)
Conference, do hereby give consent beforehand (in the event that all reachable attempts to contact me and/or
for the administration of any treatment deemed necessary by a licensed medical professional. I understand that my personal insurance is the primary insurance to be billed in the event of an accident or injury.
Please list any medical issues and/or drug allergies here: