Youth Orbit 2024 - Online Registration | Mennonite Collegiate Institute

Name *

First

Last

Attendee’s Email *

Attendee’s Phone *

Gender *

Male
Female

Date of Birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Are you currently an MCI Student? *

Yes
No

Do you currently live in dorm? *

Yes
No

Select the dates you would like to attend the event *

Friday, Jan. 12 to Saturday, Jan. 13th (overnight)
Friday, Jan. 12 and Saturday, Jan. 13th (NOT overnight)
Friday, Jan. 12
Saturday, Jan. 13

Will you need a ride? *

Yes
No

From where? *

Morden
Winkler
Altona

Please select your T-Shirt Size *

Health Information

Layout

Name on Card *

PHIN (9 digit) *

Family # (6 digit) *

Allergies/Medical concerns (list all)

Addition comments

Layout

Church affiliation (if any)

Roommate request (if possible)

Emergency Contact

Name *

First

Last

Layout

Relationship *

Phone *

I am attending Youth Orbit with the consent of my parent/guardian. *

I am attending Youth Orbit with the consent of my parent/guardian. I authorize the staff of Mennonite Collegiate Institute to act for me/my child according to their best judgment in any emergency requiring medical attention, and I waive and release MCI of any and all liability for any injuries or illnesses incurred while at Youth Orbit

Refund Policy *

I understand that until Dec. 31st, I may request a refund on individual registrations. (MCI will charge you a $30.00 administration fee.) If extenuating circumstances arise after Dec. 31st, please contact our office. These requests will be handled on a case by case basis.

Photograph Policy *

I grant MCI permission to use any photographs and/or video images of me/my child taken at the event for advertising purposes authorized by MCI.

Electronic Communicatoin Policy *

I agree to receive electronic communications from MCI for the purposes of promotion, or school information that may be of interest. I understand that I can unsubscribe at any time and that my information will not be shared at any time.

Student Price

Price: $65.00

Regular pricing – for all weekend overnight

Price: $125.00

Friday Only Price

Price: $70.00

Saturday Only Price

Price: $70.00

Friday and Saturday NOT Overnight

Price: $100.00

Credit Card *

Card

Name on Card

Powered by Stripe

Youth Orbit 2024 – Online Registration

Health Information

Emergency Contact

Youth Orbit 2023 – Online Registration

Health Information

Parent/Guardian

Request Help with Admissions