Fall Retreat Registration
Register for Fall Retreats here
Older Youth --- $45
Senior High --- $45
Junior High --- $45
Junior --- $40

Registration is now open
Retreat *
Camper's Name *
Your answer
Street Address *
Your answer
City, State, Zipcode *
Your answer
Phone Number *
Your answer
Email *
Your answer
Birthday *
Grade *
Gender *
Parent/Guardian Name *
Your answer
Parent/Guardian Phone Number *
Your answer
Payment Method *
If "Other" or "Congregation Paying" please explain
Your answer
(To pay online, please return to retreat information page and scroll to bottom)
Retreat Guidelines
Because we’re at retreat to learn more about our relationship with our Heavenly Father, it will
also be important to grow in our relationship with each other by participating in all retreat
activities. It is also to be expected that each camper will be helping with cleaning up and
other chores that may be necessary.

Off limits!
- No boys in girls’ cabin areas and no girls in boys’ cabin areas.
- Kitchen food supply areas are also restricted.
- Additional restricted areas may be determined by the directors.

Dating relationships
We’d rather you use this time to build up your relationship with God instead of building a
romantic pursuit. Stay public and take a break from hand holding, hugging, kissing, etc.

Electronic Devices
Because we’re taking time out from the usual activities that might distract us, please leave at
home any items such as cell phones, MP3 players, radios, portable game systems, etc.

Items such as tobacco, alcohol and drugs are prohibited, as campers should be receiving a
spiritual high that will surpass any man-made chemical.

Please turn in a list of any and all medications (prescription and over the counter) that the camper
will be needing during the time at camp, and the nurse will make sure campers receive them
at the appropriate times. Exceptions can be made for emergency medicine such as asthma medications, so please discuss any concerns with the nurse.

Visitors/Leaving Retreat/Phone calls
- No one will leave retreat without permission of the director. Campers who leave without permission forfeit their right to
return to the retreat.
- Visitors are not allowed during the retreat.
- Campers may make emergency phone calls by provision of the director.

Dress Respectfully
- Footwear needs to be worn at all times
- Shirts on during recreation
- Because we would like to cover rather than expose, please, no tube tops, spaghetti straps or halter tops
- Please, no clothing with logos conveying a drug, alcohol, or anti-Christian themes
Camper Agreement *
Parent/Guardian Permission *
Emergency Contact Name *
In case the parent/guardian can't be reached, please provide an additional contact in case of emergency
Your answer
Emergency Contact Phone Number *
Your answer
Emergency Contact Relationship *
Your answer
Medical Information
Insurance Company
Your answer
Policy Number
Your answer
Your answer
Last Tetanus Shot
Your answer
Your answer
Special Instructions
Your answer
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