Fall Retreat 2024 Registration

When: October 18th-20th

Where: Walnut Ridge (Morgantown, Indiana)

Who: 7th grade through 12th grade

Cost: $150

There will be a discount for families with more than one student attending this event after the first student. More than one student can be registered on this form.

How many students in your family are you registering for this event?*

onetwothreefour

To grant permission, this form must be completed, signed, and dated by parent or guardian.
Student name #1*
Student name #2
Student name #3
Student name #4
TRAVEL PERMISSION:

If transportation is provided, I give permission for my child/children to be transported by ECC Student Ministries.
Travel Permission:*

Yes- I give permission for my child/children to be transported by ECC Student MinistriesNo- I do not give permission for my child/children to be transported by ECC Student Ministries
Parent/Guardian Name:*

First NameLast Name
Cell/Phone Number*
Please enter a valid phone number.
Date*

MonthDayYear
Date
Signature*

Clear

Payment:

You may pay by cash, ECC Cash or check (made out to ECC Students), or online by credit/debit card.
I will be paying by:*

Cash/Check/Other/ECC Cash OR I am an adult volunteerCredit/Debit (Online)

Online payment (credit/debit)*

Fall Retreat Registration 20241 student

$150.00

Fall Retreat Registration 2024 2 students

$275.00

Fall Retreat Registration 20243 students

$375.00

Fall Retreat Registration 244 students

$475.00

Total

$0.00