Winter Retreat

January 10, 2025 12:00 PM - January 12, 2025 1:00 PM

44 out of 45 remaining tickets available

Type

Price

Quantity

Student

44 Remaining

Price
$145.00

Quantity

Student 0

Camp Registration

Winter Retreat 2025

Student Last Name *

Student First Name *

Parent Last Name *

Parent First Name *

Phone Number *

Email Address *

Date of Birth *

Student food allergies/ medications/ or any other pertinent information *

Student Gender *

Male

Female

Participation Agreement

1. I understand that I will be expected to keep the youth leaders informed of my whereabouts at all times and leaving the group or retreat area without a leader or leader’s permission is dangerous and not permissible.

2. I will not participate in cruel talk or mean joking.

3. I will follow the instructions of all leaders.

4. I understand that I will NOT show any PDA if I am not married.

5. I understand the need for the assigned sleeping arrangements and I will honor this.

6. I understand that I am not allowed to POSSESS or USE tobacco, alcohol, or any other type of illegal substance.

7. I understand that I am not allowed to POSSESS or USE firearms, fireworks, or any weapons on this trip.

Consequences

Section 1-4

You will be assigned an adult to spend the remainder of your time alongside. You may not get to participate in further activities.

Section 5-7:

You may be sent home immediately.

I, the guardian, and my child (children) have read and understand the participation agreement and agree to these terms *

I (We) Agree

Medical Information

Emergency Contact: First and last name *

Emergency Contact Phone Number

Relationship of Emergency contact to student *

Health Insurance Company Name *

Insurance policy/ group number *

Parental Consent

I, the parent or guardian of the student named on this application, certify that he/she has my full approval to participate in this off-campus events with the GBC youth ministry. The Youth Pastor of GBC or designated adult leader assumes responsibility for discipline during this event and reserves the right to require a student to leave the trip because of misconduct or disobedience. In such an instance, I will assume full responsibility for returning the student home.
Further, I do release and hereby agree to hold blameless Grace Bible Church, designated leaders and sponsors, and other agents from any and every claim arising, or which may be asserted by me or by any member of my family by reason of participating in this GBC sponsored event.
Further, in the event I cannot be reached by phone, I do authorize the designated leaders of Grace Bible Church to give consent to a physician and/or hospital for emergency medical or surgical treatment of my child under their supervision. It is understood that I will assume all financial responsibility for any expense that may be incurred for such treatment.
I do authorize GBC to transport my child for this event.
By clicking the box on this page I give my consent to these conditions.

By clicking this box you are agreeing that you have read and agree to the terms and conditions on this form. *

I Agree and Give My Consent