St. Mark's High School Christmas Retreat 2018
Retreat Details:

Location: Muskoka Bible Centre (MBC)
Dates: January 2 - January 4, 2018
Cost: $150
Registration Deadline: Friday, December 17, 2017

Signed form and payment are to be submitted to Karim Bishara no later than December 17, 2017


1. Fill out this form. After you click submit, you will receive an email.
2. Please print out the email. Fill in your name and your parent's name.
3. Please have both your parent and your father of confession sign the form.
4. Hand in your signed form with your payment to Karim Bishara no later than December 17, 2017.

First Name *
Your answer
Last Name *
Your answer
Email address *
Your answer
Address *
(Please include your full address, including unit/apartment/suite number)
Your answer
Grade *
Gender *
Phone Number *
Your answer
Emergency Contact Name *
Your answer
Emergency Contact Phone Number *
Your answer
OHIP Number *
Your answer
Your answer
Father of Confession *
Servant who knows you best
Your answer
Preferred Roommate(s)
We cannot guarantee that you will be roomed with your preference, but we will try our best to accommodate requests
Your answer
"I am the aforementioned participant and am 18 years of age or older, or I am the parent/guardian of the aforementioned participant who is under 18 years of age and grant the participant permission to attend the 2018 High School Retreat at MBC from January 2nd-January4th 2018. I hereby grant power of attorney and authorize the directors and/or the person responsible of the retreat to act for me/my child according to their best judgment in any emergency requiring medical attention, and I agree to take responsibility for the expenses of such a procedure. I understand that neither the organizers of the retreat nor supervising counsellors will be responsible for any injury to person or damage to property that may arise during and/or at the retreat. I understand that signing below is agreement of the above statements.” *
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