7/8th Grade Retreat in Galveston!
October 13-15 | $165

It’s time to hit the beach with all of your fellow 7th and 8th graders! The weekend will be jam-packed
with fun-in-the sun, beach games, great time with friends and an awesome evening program!! You
do not want to miss this retreat. Sign up now!

Last Name of Student *
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First Name of Student *
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Gender *
Grade *
School *
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Parent Email Address (primary) *
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Parent Email Address (secondary)
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Mother's Cell # *
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Father's Cell # *
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Student's Cell # *
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Emergency Contact (if parents can't be reached) *
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Emergency Contact # (if parents can't be reached) *
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Medical Insurance Provider *
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Medical Insurance Phone # *
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Medical Insurance ID *
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Medical Insurance Group # *
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List any allergies or medical conditions: *
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I hereby give permission for my child to attend the FPC MS 7/8 Grade Retreat to Galveston, from October 13-15, 2017, riding as a passenger in church rented bus or van. I also give permission for any member of the FPC Youth Team, in the event of an emergency, to seek dental &/or medical attention necessary for my child. *
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