Fall Retreat Registration 2017
Please fill out this registration and then make sure you download and sign the informed consent form. Registration, consent form and payment ($90) are due by September 14th. Late registrations are $100.00. (If finances are an issue for your family please email astyles@northview.org and we can make arrangements!)
Student Full Name *
Your answer
Grade *
Your answer
Gender *
Age *
Your answer
Birthdate *
Your answer
Student Email *
Your answer
Address *
Your answer
I'd like to share a cabin with...
Your answer
Parent/Guardian Name *
Your answer
Parent Email *
Your answer
Home Phone Number: *
Your answer
Parent Cell Phone:
Your answer
Emergency Contact Name (Other than parent) *
Your answer
Emergency Contact Phone Number: *
Your answer
Care Card # *
Your answer
Medical Conditions/Food Allergies *
The camp will try to accommodate for food allergies but if they are very severe and rare, student may want to bring food and snacks they can supplement for meals. (There is a fridge available.)
Your answer
Anything else?
Your answer
Consent letter Signed? *
Please download the consent letter and return the signed copy to the church by September 14th
Payment *
You may bay cash, cheque, or through Paypal. Make Cheques payable to Northview Community Church and please have payment in by September 14th.
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