Sat. Oct 14 Day Camp: "We are all Children of God"
9:00am - 3:00pm
St. Iakovos Retreat Center
Kansasville, WI
Participant Name: *
Participant Age *
Participant Diagnosis *
Any accommodations/modifications that will help make retreat successful for participant *
Food Restrictions or Allergies *
Home Parish *
Other family members accompany participant: *
Attending Parent/Guardian Contact (please include a cell phone number and email address) *
Emergency Contact Information *
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