Chill At The Hill 2019
Jr. High & High School Youth Retreat: January 25-27, 2019
Total Cost (per person): $150.00.
Cost includes: t-shirt, food, lodging, and activities

A $50 non-refundable deposit if required to secure a spot for the retreat. Please mail your $50 check to the address at the bottom of this form, or pay online at PayPal.me/hishill and write "Chill at the Hill" in the special message location.
For any questions contact us at: camp@hishill.org or by phone at: 830-995-3388

Camper Information
Please answer the following questions.
Child's Name (First & Last): *
Your answer
Street Address: *
Your answer
City: *
Your answer
State: *
Your answer
Zip Code: *
Your answer
Birth Date: *
Your answer
Age: *
Your answer
Sex: *
Current grade: *
Your answer
T-Shirt Size: *
Roommate Request (only one request please):
Your answer
Parent/Guardian Information
Please answer the following questions.
Parent Guardian Name(s): *
Your answer
Home Phone:
Your answer
Cell Phone: *
Your answer
Parents Email Address: *
Your answer
Emergency Contact (if parent cannot be reached)
Name: *
Your answer
Phone Number: *
Your answer
After we receive your completed registration form and $50 deposit, we will notify you via email with a confirmation. Please mail a check to the address below or pay online at www.paypal.me/hishill and write "Chill at the Hill" in the special message.
His Hill Retreats, P.O. Box 9, Comfort, TX 78013
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