Spring Into Action!
Serving together in the name of Jesus!
Inspired by and in partnership with Operation Inasmuch.

WHEN
April 20-22, 2017

WHERE
Camp Kinard
6053 Two Notch Rd.
Batesburg-Leesville, SC 29070

The link below takes you to Camp Kinard's website:
http://www.sclrc.com/campkinard.html

For grades 9-12
Please send 1 Adult per 5-6 youth
Sign up early, space is limited to 60!

The cost per registrant is $95, but because many congregations supplement this cost, we prefer that payment for the retreat be arranged through the congregation. If you're paying individually, please contact eric@scsynod.com to let him know that you're doing this. Checks can be made out to SCLCY, and mailed to 1003 Richland St, Columbia 29201.

Unless indicated otherwise in the comments, completion of this registration grants photo release rights for social media, annual yearbook, slideshows, and other forms of printed and digital media.

Completion of this registration also grants permission for the registrant to receive emergency medical care. Please be certain to complete the Emergency Health Form, which is in a separate survey, so that we can have accurate information in the event of an emergency during which a parent or guardian cannot be contacted.

We can't wait to see you there!

Last Name *
Your answer
First Name *
Your answer
Gender *
Date of Birth *
MM
/
DD
/
YYYY
Grade *
Name of Parent(s) / Guardian(s) *
If you're an adult registrant, please just put your own name.
Your answer
Home Congregation (Name, City) *
Example: Cedar Grove, Leesville
Your answer
Home Address — Street *
Your answer
Home Address — City, State *
Your answer
Home Address — Zip Code *
Your answer
Primary Phone — Adult *
Preferred number to reach an adult.
Your answer
Primary Phone — Youth
Preferred number to reach a youth registrant.
Your answer
Email — Adult *
Preferred email address to reach an adult.
Your answer
Email — Youth
Preferred email address to reach the youth registrant.
Your answer
Congregational Youth Leader's Name *
If you don't have a youth leader, then please provide your pastor's name.
Your answer
Youth Leader Email Address *
If you don't have a youth leader, then please use your pastor's email address.
Your answer
Roommate Preference
Please choose only one. Preferences will only be honored if both people request each other.
Your answer
T-Shirt Size *
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