Adult Spring 2025 Retreat Registration
2025 Spring Retreat--Friday Feb 21 7 pm until Sunday Feb 23 9:30 am
Important Background Check information
The Presbytery's Child & Youth protection policy requires all adults to have confirmation of a clear background check on file with the Presbytery before participating in any event involving children or youth. We are now trying to have each adult have this check run by the Presbytery's provider, Praesidium. So we are asking if you don't have a Presbytery run background check, the stated clerk will run this for you.
Church
*
Cahaba Springs
Edgewood
First, Auburn
First, Bham
First, Tuscaloosa
First, Wetumpka
First United, Forestdale
Grace
Immanuel
Independent
Mountain Brook
Oakmont Chapel
South Highland
Southminster
Westminster, Bham
Other
Church
Name, Adult
*
First Name
Last Name
Adult Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Adult Cell Phone Number
*
-
Area Code
Phone Number
Emergency Contact
*
First Name
Last Name
Emergency contact phone
*
-
Area Code
Phone Number
List any DIETARY allergies/ restrictions
*
If none, please enter none
I require an epipen
*
Yes
No
List any non-dietary allergies (i.e. bee stings)
*
If none, please enter none
I require an inhaler
*
Yes
No
List any medical conditions of participant which leadership teams should be aware of.
*
If none, please enter none
Acknowledgments and Releases
Photo release and permission to contact
*
I give permission for any photos or videos taken of me during the event by the Presbytery of Sheppards and Lapsley and/or Living River to be used for the public relations of the program.
I do not give permission
Medical Authorization and Release
*
Should I sustain or incur any accident or illness while at the event, I hereby authorize the Director and/or the Health Care provider to execute any and all documents in my behalf, including necessary releases, which might be required by a medical facility to perform emergency care.
I do not give permission
Accident Insurance Disclaimer
*
I understand I am responsible for all incurred medical expenses while at Living River
Presbytery Youth Protection Policy Compliance
*
I understand I am bound by the Presbytery's Youth Protection policy (link on Presbytery's web site and in the confirmation email) and agree to abide by the provisions in it).
Background check
*
If I do not have a background check on file with the stated clerk, I request the stated clerk to run a background check so I can participate in this event. l will receive an email from our Background check Provider (Praesidium) with instructions on how to complete this request.
Signature
*
Payment
Type payment -- Cost - $80
*
Bill the church
Bill the Presbytery
Pay by check - Payable to Presbytery of Sheppards & Lapsley
Pay by credit card
Back
Next
****Be sure to select Add to cart box below to add fee to cart****
****Please Check "Add to Cart" Below for Credit Card payment
prev
next
( X )
Add to Cart
$
80.00
Total
$
0.00
Credit Card
Back
Next
Please submit your registration! See you at Living River.
Submit
Should be Empty: