| The Central Illinois Teen Ministry |

| 2012 MIDWEST LOCK-IN: Courage!!! Saturday, March 31st - Sunday, April 1st Springfield, IL Who is Invited: YOUTH WHO ARE ACTIVELY INVOLVED IN THE ICOC YOUTH MINISTRIES. Teens (grades 9-12) and Preteens (grades 5-8) Registration Fee: $40 includes a T-shirt, snacks and dinner Saturday, and breakfast Sunday. Chaperones are free; 1 chaperone for every 10 youth Registration Deadline: FEBRUARY 27, 2012 What to Bring: Bible, flashlight, toiletries, towel, washcloth, sleeping bag/blanket, pillow, pajamas, a change of clothes (youth will wear their lock-in T-shirts on Sunday), homework, instruments (if participating in Battle of the Bands) What Not to Bring: Expensive items (electronics, jewelry, etc.) Check-in Location: Lake Springfield Christian Assembly Camp 1674 Lick Creek Lane Chatham, IL Saturday Activities: Registration 1-2pm Devotionals, Dinner, Battle of the Bands/Talent Show, Fun & Fellowship We are currently accepting entries for the Battle of the Bands/Talent Show. Interested individuals or groups should contact Dave Markowski (markowski@rocketmail.com) no later than Tuesday, February 28. Sunday Activities: Devotionals, Breakfast, Teen-led Worship Service Departure: 12 pm *NOTE: Teen and Preteen activities will be in separate locations after dinner. Registration is limited to the first 120 Pre-teens and the first 150 Teens!! Email Questions to: Derrick Williams (illiams@springfield.k12.il.us ) Jackie Williams (jelliswilliams@sbcglobal.net ) |
| PAY REGISTRATION HERE via PayPal |
| STEPS TO REGISTER ON-LINE: 1)DOWNLOAD CONSENT FORM, FILL OUT, AND EMAIL TO jelliswilliams@sbcglobal.net 2) DOWNLOAD AND PRINT GENERAL INFORMATION SHEET FOR YOUR REGISTERED YOUTH 3) CLICK ON "PayPal Payments" TO PAY FOR YOUR YOUTH'S REGISTRATION VIA PAYPAL 4) IF YOUTH IS SIGNING UP FOR "BATTLE OF THE BANDS, PLEASE HAVE THEM SUBMIT THEIR BAND'S NAME/PERFORMER'S NAME, A THREE-SONG SET-LIST TO : markowskid@rocketmail.com |

| In the event that you would prefer to pay via check and mail: Please download and fill out the consent form, make your check out to the Springfield Church of Christ. You can then mail your registration to: 3253 S. 4th Street, Springfield, Illinois 62703 |

| YOUTH MINISTRY |