Anytown Family Reunion Registration Form 

Page 1

Please select your language.
NCCJ Anytown Family Reunion Logo
Join us for a special adults-only (21+) gathering created for former Anytown participants and staff to reconnect, reflect, and celebrate the lasting impact of the Anytown experience. Back to the Mountain is a chance to come back together with old friends, meet alumni from different generations, and reignite the spirit of community, growth, and belonging that made Anytown so meaningful. 

This is an opportunity to return to the values, memories, and connections that continue to shape us. Expect fellowship. laughter, shared stories, meaningful conversations, and time to honor the legacy of Anytown while building new connections for the future. 

Come home to the mountain - we can't wait to welcome you back. 
Registration Information















By checking the text opt-in box you are agreeing to receive periodic SMS and/or MMS message from this organization. Message and data rates may apply. Text HELP for more information. Text STOP to stop receiving messages


Next page:  Emergency Contact Information

Page 2

Emergency Contact Information
Additional Emergency Contact 

In the event of an emergency during the reunion, please provide the name and contact information for the person we should notify.






Next page:  Demographic information

Page 3

Demographic Information
To ensure diversity at Anytown Family Reunion, we ask that you please check any/all of the following that apply to you:  (This information is confidential and will be viewed by NCCJ staff only.  It will not be used or disclosed for any other purposes.)









Next page: Registration Information

Page 4

Registration Options
Please review the attendance options below and select the one that best fits your plans. This helps us prepare meals, space, and materials for the weekend. 

You may register for either the full weekend experience or attend on Saturday only. 
Full Weekend Option (Thursday-Friday): 

Includes participation in all reunion activities across the weekend. Lunch and dinner will be provided each day. 

Please note:  The dining hall will not be open for breakfast during this program, so participants should plan accordingly. 
Saturday - Only Option: 

Includes participation in all Saturday programming only. Lunch and dinner will be provided. 

Please note: The dining hall will not be open for breakfast during this program, so participants should plan accordingly. 

Important Registration & Lodging Information 
Submitting this form registers you for the program only. Lodging is not included in this registration and must be arranged separately. We encourage you to contact Blowing Rock Conference Center (BRCC) directly to reserve your accommodations. 

Please note that you are not required to stay at BRCC - participants are welcome to arrange alternative lodging that best fits their needs. 

For your convenience, lodging options, including all-inclusive pricing, can be found on our website at nccjtriad.org/programs. 

Please also note that registration is not complete until your program free has been submitted. To finalize your registration, please visit: https://www.nccjtriad.org/programs/ 

Next page: Photo Release

Page 5

Photo Release

I am a participant in the NCCJ Anytown Family Reunion: Back to the Mountain and related reunion activities. I understand that I may be interviewed, photographed, or recorded on video, audio, or other digital media during the event, either alone or with other participants, staff, volunteers, or representatives of NCCJ. I also understand that I may choose to provide written or oral statements to NCCJ.

I hereby grant permission to NCCJ and those authorized by NCCJ to use these photographs, recordings, and statements to promote, publicize, and support NCCJ’s mission, programs, community education, and fundraising efforts. Such use may include, but is not limited to, social media, website content, promotional materials, newsletters, fundraising appeals, and news coverage.

I understand that these materials may be used without further review or approval by me and without compensation or financial obligation to me. I also understand that I may be identified by name, city of residence, or Anytown participation history.

I release NCCJ, its officers, Board of Directors, employees, volunteers, agents, and representatives from any claims arising from the creation or use of these photographs, recordings, or statements as described above. This consent and release shall remain in effect without time limitation.

Important Note About Photos:
Photos and videos are an important way NCCJ shares the spirit and community of the Anytown Family Reunion, especially through social media, newsletters, and printed materials. Most of our photos capture group activities and candid moments rather than individual portraits. We are thoughtful about using images in ways that reflect the positive, respectful, and inclusive values of our programs. 

We will never use a participant's image in a major marketing campaign (such as a billboard or television advertisement) without obtaining additional permission. We also do not publish personal contact information alongside participant images. 
If you do not wish to be photographed or recorded during the reunion, please contact Kelly Dawson at kdawson@nccjtriad.org or 336.272.0359 x210 prior to the event. We will work with you to make appropriate accommodations and communicate expectations in advance.