FSLDW 2026 Youth@Region Feb 18, 2026 | FSLDW - 2026 Annual Meeting 1Youth@Region and Community of Faith Information2Participant Info3Health Information / Emergency Contacts NameThis field is for validation purposes and should be left unchanged.June 5-7, 2026 ~ Mount Allison University, Sackville, NBWhat is YOUTH@REGION?Y@R is a place of community and a place of faith where United Church youth, between grade 6 and grade 12, meet from across New Brunswick, Prince Edward Island and the Gaspe. This year, Y@R will meet in-person at the same time as the online Annual Meeting of Fundy St. Lawrence Dawning Waters Regional Council (FSLDW), which is a gathering of representatives who make decisions and set policies for the United Church of Canada. The group creates an inclusive, diverse and safe community for youth in the name of Christ. We provide a place for youth to explore their faith and to learn more about the United Church of Canada while sharing in music, worship and fun in a spirit-filled community.COST AND FINANCIAL ASSISTANCEThe cost of Youth@Region is $135 per participant. This fee includes all activities, meals, accommodations, and a t-shirt. Travel expenses are in addition to this price. Don't let the cost frighten you from applying - most churches have funding available to help cover the costs! Your church, UCW and/or local community groups are good places to ask for support. Ask your minister about how these groups can help! If the local funding options are unable to help please contact the Regional Office (jwhittemore@united-church.ca). Confidentiality StatementFundy St. Lawrence Dawning Waters Regional Council (FSLDW) Youth@Region collects the information contained in this application solely for registration purposes and respects the privacy of families. We do not provide this information to any other organizations or individuals. FSLDW Youth@Region follows guidelines pertaining to applications set out by the United Church of Canada. Therefore, all documentation, whether the applicant has been accepted to Youth@Region or not, will be securely kept until the time at which it can be destroyed. Participant InformationLegal Name* First Middle Last Preferred Name/Nickname First Gender*We are asking about your gender for rooming purposes only. Click on drop-down to selectMaleFemaleNon-binaryOtherOther*Please let us know*Home Address* Street Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Home Phone*Date of Birth* MM slash DD slash YYYY Grade*Age (at the time of Y@R)*Community of Faith*Please select your Community of Faith from the drop-down below. Wondering what Community of Faith you belong to? Ask your minister! Not ApplicableOther MinistryAlberton/ElmsdaleAlma/AlbertAndrew DonaldAndover/KincardineApohaqui/Norton/Kings KirkBaie Verte/Port Elgin/Tidnish BridgeBathurstBayfield/Little ShemogueBedequeBedeque NorthBidefordBlackvilleBocabecBoiestownBridgedaleCampbelltonCanterbury/RichmondCavendish/BreadalbaneCentral QueensCharlottetown: Park RoyalCharlottetown: Spring ParkCharlottetown: TrinityChathamChipmanDalhousie-New MillsDoaktownEdmundstonFaith MemorialFredericton Council for Christian Ministry on Campus - ChaplainFredericton: Forest HillFredericton: Gibson MemorialFredericton: Marysville-PenniacFredericton: NashwaaksisFredericton: New MarylandFredericton: St. Paul'sFredericton: WilmotGagetown/Grand LakeGaspé/Cap-aux-OsHamptonHartland/JacksonvilleHarvey StationHillsboroughJolicureKensingtonKeswick RidgeKingsley/BirdtonKings UnitedLake View United ChurchLoggieville/Black RiverMargateMemorialMcAdamMcKee's Mills - RextonMillertonMillstreamMintoMiscouMoncton: CentralMoncton: Harrisville United ChurchMoncton: Mountain ViewMoncton: Mount RoyalMoncton: St. John'sMoncton: Visions UnitedMontagueMount Stewart/Morell/St. Peter's BayNashwaakNew BandonNew CarlisleNewcastleNew RichmondNewtown/WaterfordO'Leary/West CapeOromoctoPetitcodiac-SalisburyPlaster Rock/Grand FallsPrayer BenchPrince WilliamQuispamsisRed BankRestigoucheRiverview: St. Paul'sRolling DamRothesaySackvilleSaint Andrew's KirkSaint John: Carleton/KirkSaint John: Harmony United ChurchSaint John: PortlandSaint John: St. Andrew & St. DavidSaint John: St. Mark'sShediacSheffieldSouth Shore PEIStanleySt. AndrewsSt. David's, GeorgetownSt. JamesSt. Martin'sSt. Stephen: Kirk/McCollSummersideSussex: St. Paul'sTabusintacTwo RiversUpper Mills United ChurchUpper Sackville-Anderson SettlementVernon BridgeWellingtonWelsfordWest RiverWinsloeWoodstockYork/CoveheadYour MinisterEmail (Parents)* Email (Youth)* Primary Parent/Guardian Name* First Last Work Phone (including extension)CellFor emergency purposes, please provide a secondary cell/work number. Secondary Parent/Guardian NameIf the adult you travelled with is not your primary parent/guardian please put their information here. First Last Work Phone (including extension)CellFor emergency purposes, please provide a secondary cell/work number. Cell (Youth)If the youth participant will have a cell phone with them at the event, please provide their number for emergency purposes. CONFIDENTIAL HEALTH INFORMATION / EMERGENCY CONTACTSThis information will remain confidential but could help us offer appropriate support if needed.Provincial Health #*Health Card Expiry Date*Province in which health card has been issued*Emergency Contact Person*In case of emergency, should we not be able to contact your parent/guardian, please provide an alternate person who we can contact.Relationship to YouthPhone Number 1*Phone Number 2Special dietary needs or food restrictions? Explain.*Are there any medical considerations? Explain. List medications/dosages in case of emergency.*Are there any developmental or behavioural considerations? Explain.*Are there any factors that may be causing this participant stress (such as a death, separation, mental health issues in self or family member) that your child may still be coping with?*All About You!Have you ever attended Youth@Region or the former Youth Forum or Intermediates @ Conference?*Click on drop-down to selectYesNoWhich year(s)?All youth will receive a complimentary t-shirt. Please indicate what size t-shirt you wear.* Small Medium Large XL XXL XXXL Is there someone you would like to room with?Please note that this is for information, we will do our best but can not guarantee. Would you be willing to carpool?This year's business meeting is happening online while the Youth gather in person. Please indicate if you are willing to carpool, if options are available. Yes, my drive is willing to drive others Yes, I would need a drive from someone (passenger) No, unable to carpool Please take a minute to think about and answer the following questions about yourself and your interest in Youth@Region.1. Tell us something about yourself! Do you have a special talent or skill? Do you play a musical instrument?*2. If you're returning for another year, what made you apply to come back this year?Payment*Please let us know who will be paying the $135 registration fee. Myself/Family - by e-transfer Myself/Family - by cheque Community of Faith Combination of Myself/Family and Community of Faith Community of Faith Contact Name First Last Community of Faith Phone NumberCommunity of Faith Email Social Media Consent*There will be photos and videos taken during the event that may be posted to various church related online media. Indicate your preference. I give permission to be in photos and videos with my name published (name will not always be posted). I give permission to be in photos and videos without my name published. I DO NOT wish to have images and videos posted. I will do my best to remove myself from photo/video situations. Wellness*I understand that if I show up at the event with an illness of any kind I will be sent home. Yes, I understand Share this: Share on Facebook (Opens in new window) Facebook Share on X (Opens in new window) X Share on LinkedIn (Opens in new window) LinkedIn
