Registration/Permission Packet Under The Rug Serenity Christian Church 24120 N.

N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.org http://tinyurl.com/3zpapl5

Event Description
TOUGH TALK is a Christian youth conference featuring workshops lead by youth ministers and leaders from across the Metropolitan Detroit Area that tackle the hard hitting issues of sexuality, abstinence, and self-esteem. Tough Talk will also feature workshops on empowerment and life skill development. Youth will be placed into groups by gender for the first two workshops and then brought together for a panel discussion at the end of the day. The event will occur on Saturday October 1, 2011 from 10:00am -4:00pm (Please See Attached Schedule)

Under The Rug

TOUGH TALK is hosted by Serenity Christian Church and UNDER THE RUG. UNDER THE RUG is a new Ministry with the mission to equip Christians with the necessary skills to address, discuss, and break free from sexual sin! All programming efforts as described in the mission are in the attempt to contribute to the expansion of Gods Kingdom, therefore Under the Rugs greatest commitment is to win over those living in sin to the truth of the bible, comfort of the Holy Spirit, and vision of Jesus Christ. After hosting several successful events including the Under the Rug Kick Off Celebration, Homosexuality 101, and Porn Sunday, many parents requested that Under the Rug host an event that specifically dealt with the issues faced by todays youth. TOUGH TALK is the product of parental requests and was designed to cater to the needs of todays youth.

Who is Benjamin?
Benjamin Williams is a native Detroiter, committed to launching initiatives that focus on the revitalization of Detroits social and artistic culture; specifically those that meet the needs of todays youth. This goal is evident in his work as Director of Theatrical Outreach Programming for People Mover Productions; Director of Education Programming for The Arts League of Michigan; Program Coordinator and Teaching Artist with The Mosaic Youth Theatre of Detroit; The Theatrical Artist in Residence with the Charles H. Wright Museum of African American Historys CAMP AFRICA and his research endeavor: Stanislavski's System of Acting as Applied Theatre for Youth Empowerment. Benjamin accepted Christ at the age of 16 at Mt. Olive Baptist Church in Detroit, MI. In January of 2011 Benjamin accepted the call to found and lead the untraditional ministry of Under The Rug after realizing the necessity of a ministry that educated and discussed Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com

Registration/Permission Packet Under The Rug Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.org http://tinyurl.com/3zpapl5 issues of sexuality and sin tactfully and candidly in the Body of Christ. (www.benjaminjohnwilliams.com)

REGISTRATION FORM
PARENTAL PERMISSION IS REQUIRED FOR YOUR YOUTH TO PARTICIPATE Please complete the attached Registration and Parent/Youth Contract and return to Benjamin Williams. Your youth must have all materials turned in to participate in the conference. Youth Name: ______________________________________________________________Age: ____________ Address: ___________________________________________________________________________________
Street City State Zip

Youth Cell Number:__________________________ Other Phone: _____________________________________ Youth Email: _______________________________ Parent/Guardian Name: ______________________________________________________________________ Cell Phone:__________________________________ Other Phone: __________________________________ Parent Email:________________________________ Emergency Contact Name:____________________ Emergency Contact Number:________________________ Emergency Contact Relationship to your child:__________________________________ Does your child have any allergies or reactions? (i.e. food, medication, etc.): No___ Yes___ If Yes, please explain: ______________________________________________________________________________ Will your child be taking any medications or treatments during their participation in TOUGH TALK? No___ Yes___ If Yes, please explain: ______________________________________________________________________________

Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com

Registration/Permission Packet Under The Rug Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.org http://tinyurl.com/3zpapl5 WAIVER: I authorize Serenity Christian Church staff, ministers, and volunteers, to transport the above named participant to the nearest hospital in case of injury or illness while the participant is attending TOUGH TALK if the parent/guardian cannot be reached. I further authorize the hospital attending physician to administer necessary emergency professional medical care to my child. Parent/Guardian Signature: ______________________________ Date__________________

PARENT/YOUTH CONTRACT
I, ____________________________________ agree to the following, as a condition of my participation in TOUGH TALK: (Youth Participant) I will attend all scheduled sessions. I will arrive on time, prepared, and cooperative. I will respect my leaders and other participants in the program I understand that this is a Christian Conference that will cover topics that include Sex, Sexuality, Puberty, Abstinence, Youth Empowerment, Life Skills and Leadership. My parent(s)/guardian(s) understand that this is a Christian Conference that will cover topics that include Sex, Sexuality, Puberty, Abstinence, Youth Empowerment, Life Skills and Leadership. I will be a mature young person during all discussion and workshops. I will have fun!

Youth Signature: _________________________________________________Date:___________________ Parent Witness Signature:__________________________________________________ Date:___________

Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com

Registration/Permission Packet Under The Rug Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.org http://tinyurl.com/3zpapl5

EVENT SCHEDULE
Saturday October 1st 10:00am-4:00pm @ Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 10:00am Parent and Youth Arrival (Light Breakfast Refreshments) 10:00am-10:45am Parent and Youth Orientation 10:45am Parents Dismissed and Youth Placed in Gender Groups 11:00am 11:55am Session 1 11:55am-12:05pm Break 12:05pm-1:00pm Session 2 1:00pm-1:45pm Lunch/Games 1:45pm-1:55pm Combine Groups Ice Breaker 2:00pm-3:15pm Panel Discussion/ Q & A 3:30pm Parents Arrive 3:30-4:00pm Parent and Youth Debrief Call 313-915-0292 for any questions. _______________________________________________________________________________

Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com

Registration/Permission Packet Under The Rug Serenity Christian Church 24120 N. Chrysler Drive, Hazel Park, MI 48030 (313) 915-0292 www.serenitychristianchurch.org http://tinyurl.com/3zpapl5

All Workshop Leaders/Volunteers are Master Working Professionals In Their Ministry

Completed Registration Forms can be Faxed to (248) 547-2122 or emailed to serenityundertherug@gmail.com