CHOSEN 2025 – auc.bluevineyardevents.com

Application type

Delegate

Staff Mentor

Please type your staff mentor code to continue

The staff mentor code you used is not correct. Please go back and correct it or contact your youth department to request the correct code.

Compulsory Documents

The following documents are COMPULSORY for all staff attending Chosen:

1) You will need to complete and pass AdSafe Awareness Training.

2) You will need to complete and pass AdSafe Code of Conduct.

3) You will need to upload your Working with Children Card (WWCC) or equivalent.

Do you have all three compulsory documents ready to be uploaded?

Yes

No

Please upload your three documents.

Choose File

If you have not completed or are not up-to-date with the Adsafe training or the code of conduct , please go to the AdSafe website, https://elearning.adsafe.org.au/ to complete the training and code of conduct.

If you do not have a Working with Children Card please apply for one at your state’s website.

Personal Details

The details below are of the registrant (delegate/mentor) attending Chosen.

First Name

Last Name

Gender

Phone Number

Date of Birth

Email Address

Address

Address Line 1

Address Line 2

City

State

Postcode

Country

Local Conference

Name of your home church

Parent/Guardian Personal Details

Parent/Guardian’s First Name

Parent/Guardian’s Last Name

Parent/Guardian’s Phone Number

Parent/Guardian’s Email Address

Relationship to the registrant

This parent/guardian is the emergency contact of the registrant.

Yes

No

Emergency Contact’s First Name

Emergency Contact’s Last Name

Emergency Contact’s Phone/Mobile

Emergency Contact’s Email Address

Relationship to the registrant

T-Shirt

T-shirt size

Meals

Vegetaian food will be served. If you do have special diet requirements or any allergies, please let us know and we will try our best to cater to your request.

Do you have any special diet requests?

Yes

No

Special Diet Request

What other dietary requirements do you have?

Medical Information

Blood Group

Medicare Number

Position on card

Private Health Insurance provider

Private Health Insurance membership number

Doctor’s Details

Doctor’s Name

Doctor’s Phone Number

Medical Conditions

Please select all that apply to you and provide additional information for all items selected.

Medical Conditions

Please provide additional information for the item/s you selected above.

Travel Details

How will you be traveling to Chosen?

AUC Youth will be booking and organising all flight arrangements. Delegates will be flying on the same flight as their mentor(s).

All departing flights will be booked for the morning/noon of 7 July to Brisbane and returning flights on the morning/afternoon of 11 July from Brisbane.

Please be patient, we will definitely reach out to you regarding your flight itinerary.

Departing Airport

Are you returning to the same airport you departed from?

Which airport will you be flying back to?

I would like to take the bus shuttle service provided by AUC Youth from Brisbane Airport to QCCC Brookfield.

Yes

No

Please provide any comments you have regarding your travels.

*Sorry, we are unable to accept your registration. Please come back when you are ready to upload your 3 documents:

1) AdSafe Awareness Training

2) AdSafe Code of Conduct

3) Working with Children Card (or equivalent)

Terms and Conditions

In the event of accident or illness, I authorise the Event Director to seek appropriate medical treatment, and consent (where it is impractical to communicate with me) for me/my child to receive an x-ray examination, medical or hospital treatment as may be deemed necessary by a licensed physician and/or surgeon.

I agree to meet the expense of me/my child being returned home by the director or leaders due to illness or injury.

I understand that photos and videos of the Chosen National Teen Leader’s Convention will be taken and used during the program and in other Youth Ministries promotions and events.

I have read and agree to the Terms and Conditions.

Delegate

Delegate Registration $240.00

No payment items has been selected yet

Pay with Card (Stripe)