California Teen Event Application

A Beautiful Day in Southern California

for Girls who have Lost a parent

Bethany Hamilton invites pre-teen and teenage girls who have lost a parent in recent years to come meet her for a day of pampering in beautiful Southern California! You’ll get to enjoy a pool party, games, arts and crafts, delicious meals, plus photos with Bethany. Most importantly, you’ll be in a loving community of other girls who have been through the same thing.

Dates: October 21 or 22

Location: Temecula, CA

Cost: Only $45!

Scholarships may be available to help with fees. Please notify our team if that is a challenge for you. Don't let it hold you back from applying!

Application

Please complete the application with your parent or guardian.

Questions? Please call Program Director, Lindsey, at 360-739-7743
General Information
Applicant Name(s)*

First NameLast Name
Parent/Guardian Name *

First NameLast Name
Parent/Guardian Email*
example@example.com
Where do you live?

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Applicant's Age
Applicant's Birthday*

MonthDayYear
I can attend:

Saturday, October 21stSunday, October 22ndEither day works for me!
We want to know you better!
Tell us your story!*
Why do you want to attend? *
How old were you when your parent passed?
What are your interests?
What are your favorite foods?
Are you connected with a counselor, church group, etc. Please describe.
Make us aware of any special needs or allergies*
Participants will be expected to provide their own transportation. We understand that transportation may be a challenge; please choose from the following:

I can get a ride to and from event.I may need help with transportation.
There is a registration fee of $45 to secure your spot. The fee will be due upon notification of acceptance.

You'll choose between, or be assigned to, one of the two retreats being held - Saturday, October 21st or Sunday, October 22nd.
I understand the cost, and dates.*

I understand and agreeDecline
If accepted, what challenges might you need to overcome to participate in this event? And/Or is there anything else you'd like to tell us?
Applicant Signature*

Clear
Parent or Guardian Phone Number*
Please enter a valid phone number.
Parent or Guardian Signature*

Clear
Thank you for completing this application!

Applicants will be notified of acceptance on a weekly basis between September 1st and October 19th.
Should be Empty:

A Beautiful Day in Southern California

for Girls who have Lost a parent

Application

General Information

We want to know you better!