If you wish to participate in D-NOW 2010, please fill out the registration form below. Deadline to register is at midnight on August 1st, 2010 Name:  * required Age:  * required Gender: Male Female Mailing Address  * required City:  * required State:  * required Zip Code: Email Address:  * required Home Phone:  * required Emergency Contact Phone  * required Emergency Contact Name  * required Relation to You:  * required What School Do You Attend?  * required Current Grade (Fall Semester 2010) 6th 7th 8th 9th 10th 11th 12th Have you attended an HSM D-NOW Weekend before? Yes No T-Shirt Size Small Medium Large X-Large 2XL 3XL 4XL Do you have any known allergies? Yes No If Yes, please explain: Are you currently taking any kind of medication that you will be required to take during HSM D-NOW Weekend 2010? Yes No If Yes, Please list and explain dosage:   (Please read the following terms of agreement)  In understanding that HSM desires that I have the safest and most beneficial weekend possible, I promise to abide by all rules and regulations set forth by HSM during my participation in D-NOW 2010. I also understand that HSM reserves the right to dismiss me from all weekend activities due to any destructive or inappropriate behavior on my part. In the event of a dismissal from D-NOW 2010 (due to any destructive or inappropriate behavior), HSM will not refund my registration fee and my involvement in any future HSM events will be uncertain. Agree Disagree   It is the goal of HSM (Hindman Student Ministries) to provide you with the opportunity of experiencing one of the best weekends of your life here at D-NOW 2010 (Disciple Now Weekend). HSM promises to do everything in our power to make sure your experience with us is safe and most of all, life-changing through the power of God’s Word. We invite you to be part of this amazing weekend event as we are blown away by the “Crazy Love” of our God and come to the understanding of how “Crazy” our love toward Him should be in return.     “For Christ's love compels us, because we are convinced that one died for all, and therefore all died. And he died for all, that those who live should no longer live for themselves but for him who died for them and was raised again.”   - 2 Corinthians 5:14-15 -