Feb­ru­ary 21–22 
6th — 12th Grade
Par­tic­i­pants will return to their homes to sleep
Cost: $30, includes T‑Shirt, Mate­ri­als, Snacks & 3 Meals
Appli­ca­tions due by Feb­ru­ary 14, 2018
2/22 6pm-10pm, Super & Snack Served
2/23 9am-4pm, Break­fast, Lunch, & Snack Served 
You can down­load, print, and send in your reg­is­tra­tion form and pay­ment by Click­ing Here
Or by fill­ing out the form & pay­ment below ($1.20 Pay­Pal fee includ­ed)
Please mail to Daniell Bap­tist Asso­ci­a­tion, P.O. Box 388, Ailey, GA 30410

Pass­word must be at least 7 char­ac­ters long.
Pass­word must be at least 7 char­ac­ters long.
Address Line 1  *
City  *
State or Region  *
Zip  *

By Check­ing & Tying your name below you agree: As a par­tic­i­pant I agree to abide by all the rules set forth by the DBA SURGE com­mit­tee. I fur­ther under­stand that fail­ure on my part to com­ply with rules and direc­tions giv­en by the event orga­niz­ers and youth lead­ers that are serv­ing as coun­selors and chap­er­ones of the event will mer­it my imme­di­ate dis­missal at my parent/guardian’s expense.

By Check­ing and Typ­ing your name below you agree: As a parent/guardian I agree to allow my child to attend Win­ter Surge. I under­stand that the event orga­niz­ers, the DBA, indi­vid­ual DBA church­es or FBC Mt. Ver­non, will not be held liable for injuries incurred as a result of my child’s atten­dance at this event. Should injury or ill­ness, oth­er than minor, arise, I give my per­mis­sion for med­ical care to be pro­vid­ed. I shall be ful­ly respon­si­ble for pay­ment of such cost. I also give my per­mis­sion for any pho­tographs tak­en of my child to be used for pos­si­ble pro­mo­tion pur­pos­es. I also give my per­mis­sion for my child to be trans­port­ed from FBC Mt. Ver­non to par­tic­i­pate in a local mis­sion project.

Sched­ule: Fri­day, Feb­ru­ary 21 arrive for sup­per & activ­i­ties @ 6:00 pm Depart for home @ 10:00 pm Sat­ur­day, Feb­ru­ary 22 arrive for break­fast and a full day of activ­i­ties @ 9:00 am. Depart for home @ 4:30 p.m.

If you have any ques­tions, please call Lau­ra Hay at 253‑0041 or Tabitha Brad­dy at 253‑2896