Fall Beach Retreat 2019
DETAILS
6th-12th Grade youth and friends

Friday, September 20 @ 5pm
TO
Sunday, September 22 @ 2pm

$100

Registration Deadline: Sunday, September 15
PERSONAL INFORMATION
First Name *
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Last Name *
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Church Association *
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Address *
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City/Zip *
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Home Phone *
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Age *
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Birthdate *
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School *
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Grade *
Youth Email *
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Youth Cell Phone *
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Emergency Contact NAME *
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Emergency Contact PHONE NUMBER *
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Allergies / Medical Conditions *
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Permission
I give permission for my son/daughter to attend the Fall Beach Retreat 2019 sponsored by the McMinnville Youth Collective (MYC) on September 20-22, 2019. I understand that in the unlikely event of an accident or illness, every effort will be made to contact me at the phone numbers given. In the event I cannot be reached, I hereby authorize the adult leaders of MYC to take whatever medical attention deemed necessary, including securing the opinion and service of a physician or hospitalization.
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Photo & Video Release
I give permission to the McMinnville Youth Collective to photograph & video my child during this event. I give permission to copyright, use, and publish the photographs & video for any lawful purpose, including church publications, the church website and social media sites. I have read and understand these statements.
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PARENT/GUARDIAN INFORMATION
Parent/Guardian Name *
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Parent/Guardian Email *
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Parent/Guardian Cell Phone *
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