11th & 12th Grade Winter Retreat Registration
STAND FREE: Freed to Act!
"Christ has broken our enslavement to sin and set us free! So stand as free people, and never be slaves again!"
— Galatians 5:1

RETREAT DESCRIPTION HERE

***Please be certain to fill out the LCY Emergency Medical Information & Permission form!*** http://scsynod.us/lcymedicalinfo

WHEN IS THIS RETREAT?
February 17-19, 2017
Arrive Friday evening 5:30-6:15 for registration
Depart Sunday morning after worship

WHERE IS IT?
Costal Retreat Center
2101 Palm Blvd
Isle of Palms, SC 29451

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

WHO CAN COME?
Current 11th & 12th Graders

Share this registration with your friends!
Individual Registration – http://scsynod.us/lcy1112wr
Group Registration – http://scsynod.us/lcy1112wrgroup

WHAT IS THE COST?
$95 per registrant. 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 so Pastor Eric knows to be on the lookout for your check.

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!


This is a link to all our LCY Registrations for events! http://www.scsynod.com/youth

Last Name
Your answer
First Name
Your answer
Gender
Date of Birth
MM
/
DD
/
YYYY
Grade
Name of Parent(s) / Guardian(s)
Your answer
Home Congregation
Your answer
Home Address — City
Your answer
Home Address — Zip Code
Your answer
Primary Phone — Youth
What's the best number to reach the registrant?
Your answer
Email — Parent & Youth Leader
This information sends an email confirmation to the parent / guardian of our registrants and to the youth leader of the congregation to which the youth belongs. Type the emails separated by a comma (you can add other email addresses this way as well). They should look like this: parent@altavista.com, youthleader@congregation.com
Your answer
Email — Youth
What's the best email to reach the registrant?
Your answer
Email — Congregation Youth Contact Person
What's the best email to reach your congregation's youth contact person?
Your answer
Roommate Request
Select ONE person who you'd like to room with. Requests are honored only if two people request each other.
Your answer
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