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PhLY Winter Retreat Registration
Phoenix Lutheran Youth Winter Retreat: Extreme Me
Shepherd of the Hills Lutheran Church
1601 N San Francisco St, Flagstaff, AZ 86001
Martin Luther King Weekend
Friday, January 17 - Monday, January 20

Mission: Empowering the youth of today to be the spirit filled leaders in their communities.

Vision: Through four days of Christ centered activities, personal testimonies, and community building youth will have a positive self-worth and understanding of their gifts and how to serve their community to the glory of God.
Name: *
Your answer
Church: *
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T-Shirt size: *
Emergency Contact name: *
Your answer
Emergency contact number: *
Your answer
Any dietary concerns or allergies? *
If you have dietary concerns please list in detail any allergies or dietary lifestyles our cooks need to know about.
Your answer
What medications are you prescribed? *
Your answer
I give my consent that my child can participate in all group games. *
I give my consent that my child can be photographed with the understanding those photos can be published on social media. *
I give my consent for my child to be transported to Canterbury Campus Ministry and back to Shepherd of the Hills. *
I give my consent for my child to walk to Bison Park with the group during the scheduled recreational break. (about a ten minute walk) *
My youth will need transportation to and from Flagstaff. *
I am willing to carpool other youth to Flagstaff *
My pastor knows and supports my youth attending the PhLY Winter Retreat. *
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