2021 Summer Retreat Registration Form
Retreat Dates: July 22-24, 2021
Theme: Fully Known, Deeply Loved

Speakers: Josiah Cha and HYM Staff
Worship: Chelsea Han and Company
Details: Retreat will begin on Thursday night and conclude to Saturday night, with each day starting at 9:00 AM to 11:00 PM. No sleepovers will be held at church.

Early Bird Registration: $20 (By Sunday, July 4)
Regular Registration: $30 (By Sunday, July 11)
Final Registration: $40 (By Sunday, July 18) *No Sibling Discount by this deadline.
Make checks payable to "KPCO."
Scholarships are available - talk to Josiah Cha or Pastor DL for information.

Josiah Cha: jsc4fd@virginia.edu | 703-939-5536 (Cell) Rev. DL Kim: davidlarry@gmail.com | 407-654-3908 (Church)


Spirit of God: Pray that God would be welcomed into each heart. If students don’t recognize that God is with us, they will miss out on all that God wants to do in them. We desperately need His presence to meet us there!
Students: Pray for hunger to know Him and to surrender their lives to Him before, during and after the retreat.
Speaker: Pray that God would anoint our speakers.
Small Groups: Pray that teachers would help students meet God in a special way and that God would use servant-leaders to minister to our youth.
Safety: Pray for health and safety.
Praise Team: Pray that the praise team leads us to an intimate place of worship.
Planning: Pray that pastors, teachers, students who are planning the retreat would be filled with God’s wisdom.
Parents: Pray that parents would be excited and prayerful as they provide support.
Sign in to Google to save your progress. Learn more
Student Name: *
Student Email: *
Student Cell # *
Date of Birth: *
Grade (Just completed): *
Gender *
Emergency Phone # *
Parent/Guardian's Names *
Food/Medicine Allergies/Comments
For parent: I give my child permission to attend the 2021 HYM Summer Retreat. In the event of an accident or illness, I request that the church contact me. If I cannot be reached, the church can take whatever arrangements necessary to provide emergency care and treatment for my child. I will assume responsibility of payment for services rendered. *
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy