New Year Retreat 2025

New Year Retreat Registration
Guys, New Year Retreat is going to be awesome! We are all headed to the Saddleback Church Rancho Capistrano Campus Retreat Center in San Juan Capistrano, CA from January 24-26 to connect with God and connect with each other. It is a great way to deepen your relationship with Jesus and your community. Can't wait to hangout with you there!
Full Name*

First NameLast Name
Phone Number*
E-mail*
Gender*

FemaleMale
High School Grad Year*
Saddeback Campus*
Sweatshirt Size*
GROUP REQUEST

Everyone will be a member of a retreat group. Use the section below to request people to be in your group.
Life Group Leader
If Applicable
Group Request #1
Group Request #2
NEW YEAR RETREAT COMMITMENT
What to expect:

You are about to embark on a weekend designed to challenge you in your faith and push you to a new depth in your relationship with God. This retreat will NOT be your average weekend! We are glad you decided to come and we are confident that God will speak directly to you. For the next two nights, you will be living in community. To do this well and to ensure a positive experience will take some effort on your part. Rather than assuming that we are all on the same page, we thought we would make it easy and spell out exactly what will be expected of you this weekend. If you decide that you cannot live according to these guidelines, that is fine; just know that we cannot allow you to join us on the retreat. As you know, this CM trip is sponsored by Saddleback Church. Therefore, this trip was planned with the following values in mind: spiritual growth, community, honesty, and fun. To be sure these values are realized, we are asking that you comply and agree with the following
Rules:
- I will always act according to common sense and promise to consider the consequence of my actions.
- I will not bring or buy ANY drugs, alcohol, cigarrettes, or weapons
- I will not bring marijuana/THC products of any kind
- I will not harm, or do anything that might cause harm, to any person or any person's personal property while I am on the retreat.
- I will not bring a firearm of anykind, even if I have a concealed carry permit
- As an adult, I know I'm financially responsible for things that I damage.
- I will not display a lack of respect or lack of cooperation to anyone in leadership on this trip.
- I will not go into the room of an opposite gender.
I understand that if I choose not to comply with any of the above guidelines, I will be asked to leave the trip and will need to make my own arrangements to return home at my own cost.
MEDICAL TREATMENT CONSENT & RELEASE OF LIABILITY FORM
In the event that I am injured while participating in New Year Retreat, January 24th–26th 2025, I do hereby authorize and consent to any x-ray, examination, anesthetic, medical, or surgical diagnosis rendered under general or special supervision of any licensed medical staff member under the provisions of the Medicine Practice Act.
It is understood that this authorization is given in advance of any specific diagnosis or treatment being required, but it is given to provide authority and power to render care which the aforementioned physician, in his or her best judgment, may deem advisable.
It is understood that effort shall be made to contact, the undersigned, prior to rendering treatment, but that any of the above treatment will not be withheld if no one can be reached. This authorization is given pursuant to the provisions of section 25.8 of the Civil Code of California.
I understand the retreat setting and nature of this event and do hereby release Saddleback Valley Community Church, or any of its staff or representatives, volunteers or the like, for accidents or injury sustained in conjunction with CM’s 2025 New Year Retreat in San Juan Capistrano, CA.
Do You Agree?*

I Agree
Signature
Emergency Contact*

First NameLast Name
EC Phone Number*
EC Relationship*
Policy #
Insurance Carrier
Family Doctor
Doctor's Phone #
Are you taking any medications regularly?
Please List Them
Diet Accommodations
We can help accommodate for the above diets.
Major Allegries
Please List Them
Are there any special physical problems of which we should be aware of ?
PAYMENT OPTIONS

We have two different payment options for this retreat: full payment and payment plan. Please use the information below to find which option is best for you. A full payment will charge your card $79 immediately. The payment plan will charge a $50 payment today with two monthly payments of $15 that will occur exactly one month after each other. (ex. if you pay on 11/15/24, your next payments will be on 12/15/24 and 1/15/25). *Note: Whether you choose to pay in full or enroll in a plan, the $50 deposit is NON-REFUNDABLE. Any cancellations made December 18, 2024 or after will result in a $0 refund.
WHETHER YOU ARE CHOOSING THE PAYMENT PLAN OR FULL PAYMENT OPTION, PLEASE READ THE TERMS AND CONDITIONS BELOW AND CLICK THE BOX UPON AGREEMENT.*

I understand and agree that any subsequent payment(s) on my payment plan will be charged to my credit card on the same date as today’s date each month until final payment is made. If any payment is declined for any reason, I will contact Colton Harker at DelaneyK@saddleback.com within 48 hours to initiate a new payment plan or pay the balance in full.

Payment Options*

CM NYR Full Payment($79.00 one-time payment)

CM NYR Payment Plan($50.00 for the first month then,$15.00 for each month)

First Payment: $50 // Second & Third Payment: $15

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

The last step would be to press submit and you will get a confirmation email as soon as possible! Please contact Delaney Kansiime at DelaneyK@Saddleback.com if you have any questions.
Should be Empty:

New Year Retreat Registration

GROUP REQUEST

NEW YEAR RETREAT COMMITMENT

MEDICAL TREATMENT CONSENT & RELEASE OF LIABILITY FORM

PAYMENT OPTIONS