2022 Winter Retreat Registration

Winter Retreat Church Registration - 2022

Jr. FreezeOuts & Teen Meltdowns
This form is the Church Registration Form to be used by church groups registering for the Winter Retreats (individual campers should not use this form, please call our office with any questions).

Medical Release Form - Must be filled out by each camper attending. Forms must be submitted to IRBC via email (camp@irbc.org) 7 days prior to the start of the retreat.
Your Name *

First Name Last Name
E-mail *
Phone Number

Area Code Phone Number
Church Name *
Church City *
Retreat Attending (Choose One) *
Retreat Attendees

Fill in the number of campers & counselors attending!
Female Campers *
Female Counselors *
Male Campers *
Male Counselors *
T-Shirt Order - Free!

Please indicate how many of each size you'd like to order for campers & counselors!
Youth Large
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Payment

Campers

Campers (Two Day) $ 60.00

Quantity
Item subtotal: $ 0.00

Counselors (Two Day) $ 30.00

Quantity
Item subtotal: $ 0.00

Campers (Three Day) $ 80.00

Quantity
Item subtotal: $ 0.00

Counselors (Three Day) $ 40.00

Quantity
Item subtotal: $ 0.00

Total $ 0.00

Winter Retreat Church Registration - 2022