Friday, February 10th - Saturday, February 11th
Sunday, January 15th
Whitetail Resort13805 Blairs Valley Rd.Mercersburg, PA 17236
Pine Creek Retreat Center1794 Back Creek RoadGore, VA 22637
$125.00 *(See note below)
*Note: Please pay online here or make check out to Pasadena Assembly of God.
I, Full Name give permission for my child: Full Name* to attend the Winter Blast Retreat on Friday, February 3rd and Saturday, February 4th.
Do any of the following conditions exist?Asthma: If so, what is used for the attack? Allergic to medication? What kind? Any other medical conditions that we should know about? Explain:
In case of accident my Insurance Company Is: * My Policy Number is: *