We're sorry, registration for Regeneration is now closed.

Personal Info

First Name
Last Name
Staff?
Spouse
Spouse's First Name
Spouse's Last Name
Staff?
Spouse's E-mail
(please use your primary e-mail address to receive all Regeneration info)
Confirm Spouse's E-mail
* Birthdate
Young Adult Leader?

How are you active in Young Adult Ministry?

Gender
Dietary Restrictions





Other:

Agreements
By checking this box I personally assume responsibility for my actions, and release The Salvation Army from loss, injury or damage to myself or my property provided that nothing contained herein shall excuse The Salvation Army from responsibility to act with reasonable care for the health and safety of myself or my property.
By checking this box I hereby give The Salvation Army permission to use photos of me involved in Regeneration activities in their publications, promotions or other ministry materials. If you choose not to check this box, complete your registration and then email a photo of yourself, spouse and/or children to USC_Youth@usc.salvationarmy.org as soon as possible.
By checking this box I hereby give permission to the medical personnel selected by the conference director to order x-rays, routine tests, treatment; to release any records necessary for insurance purposes, and to provide or arrange necessary related transportation for me. Should any dispute or controversy arise, I agree to seek resolution according to Biblical principles.
Not a Member?

We are glad that you want to attend Regeneration 2020! Because we don’t know you (yet) we’ll need you to pay for your registration before 1/27/2020. Please pay now to confirm your registration. If you are unable to pay when you complete this form, please email dawn.tooley@usc.salvationarmy.org for your individual payment link. If we do not have your payment before 1/27/2020 your registration will be cancelled.

If you would like to be housed with someone who IS a member of The Salvation Army, please let us know who they are below

Salvationist's First Name
Salvationist's Last Name
Mailing Address
City
State
Zip Code
Phone
Division
Other
Corps
E-mail address
(please use your primary e-mail address to receive all Regeneration info)
Confirm E-mail address
* Birthdate
Young Adult Leader?

How are you active in Young Adult Ministry?

Gender
Dietary Restrictions





Other Restrictions
Emergency Contact
Name
Relationship
Phone
Comments


Registration Fees

Registration and meals
$0
# of Children (Only children age 0-5 allowed):  
($20.00 per child)

$0

(You will need to email photo(s) of your child(ren) for our reference at USC_Youth@usc.salvationarmy.org)
#1 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#2 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#3 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#4 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#5 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#6 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#7 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#8 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#9 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

#10 First Name:
Last Name: 		DOB:
Diet Restrictions






Other:

Total amount due$0

Agreements

You must check all of the following boxes to indicate your agreement with these statements before submitting your registration.

By checking this box I personally assume responsibility for my actions, and release The Salvation Army from loss, injury or damage to myself or my property provided that nothing contained herein shall excuse The Salvation Army from responsibility to act with reasonable care for the health and safety of myself or my property.
By checking this box I hereby give The Salvation Army permission to use photos of me involved in Regeneration activities in their publications, promotions or other ministry materials. If you choose not to check this box, complete your registration and then email a photo of yourself, spouse and/or children to USC_Youth@usc.salvationarmy.org as soon as possible.
By checking this box I hereby give permission to the medical personnel selected by the conference director to order x-rays, routine tests, treatment; to release any records necessary for insurance purposes, and to provide or arrange necessary related transportation for me. Should any dispute or controversy arise, I agree to seek resolution according to Biblical principles.

Completing your registration


Check that all of the information entered above is correct and then click the "Submit Registration" button below to process your registration.




*You must be between the ages of 18-29 (by 2/14/2020) OR active in young adult ministry on the local Corps or Divisional level to attend.