6th Grade Retreat @ Camp ChoYeh!
Join us for a GREAT WEEKEND of...

Survivor competitions, fun games, swimming, lake activities, and awesome night programs & more!

September 22-24, 2017
$150
Drop off at FPC at 6 pm (Eat dinner before you come!)
Pick-up at noon on Sunday at FPC

Last Name of Student *
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First Name of Student *
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Gender *
School *
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Parent Email Address (primary) *
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Parent Email Address (secondary)
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Mother's Cell # *
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Father's Cell # *
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Student's Cell # *
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Emergency Contact (if parents can't be reached) *
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Emergency Contact # (if parents can't be reached) *
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Medical Insurance Provider *
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Medical Insurance Phone # *
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Medical Insurance ID *
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Medical Insurance Group # *
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List any allergies or medical conditions: *
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I hereby give permission for my child to attend the FPC MS 6th Grade Retreat at Camp ChoYeh, from September 22-24,2017, riding as a passenger in church rented bus or van. I also give permission for any member of the FPC Youth Team, in the event of an emergency, to seek dental &/or medical attention necessary for my child. *
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