Youth Girls Mini Retreat

Name of Student

Student's Phone

Student's Date of Birth

Address

Parent/Guardian's Name

Parent/Guardian's Phone

Parent/Guardian Email

This address will receive a confirmation email

Secondary Emergency Contact and Phone Number

Health Insurance Carrier and Policy Number

Any Allergies/Disabilities?

I understand all reasonable safety precautions will be taken at all times by Faith Community Church and its agents during the event and activities. I authorize any treatment by an accredited hospital and/or physician deemed necessary for the subject of the release in case of an emergency. I understand the possibility of unforeseen hazards and know the inherent possibility of risk. I agree not to hold Faith Community Church, its leaders, employees, and volunteer staff liable for damages, losses, diseases, or injuries incurred by the subject of this form. I give permission for my son/daughter to attend.

cost- $15

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Description

October 16-17

The girls mini retreat will feel like a giant slumber party at the church playing games, eating together, and hanging out. This event is geared towards having fun, creating community with us girls, and learning more about ourselves and God.

Suggested Cost is $15 (meals included)

Drop off: Friday October 16 at 5:30pm
Pick-Up: Saturday October 17 at 12pm

What to Bring:
*Water Bottle
*Sleeping bag or blankets
*pillow
*sleeping mat/pad (We are sleeping on the floor)
*Pajamas
*Toothbrush/paste
*Other personal toiletries if needed
*Change of Clothes
*Journal (we have extra if you don't have one)
*Bible (we have extra if you don't have one)

Youth Girls Mini Retreat

Description

Please Fix the Following