GA NYI Fall Retreat | Adult Registration
Use this form to register a student (grades 6-12) for the Georgia NYI Fall Retreat. The Retreat will be held at the FFA Campground in Covington, GA and will be October 31st - November 2nd 2025
Registration Costs and Deposit
Your Registration Cost is based on the postmarked date of the deposit check sent by the church you are attending with (see below). The cost scale is as follows:Deposit at all levels: $50 (Non-refundable, but transferable)Cost if postmarked by: September 17th: $194 (guaranteed Event Clothing), October 1st: $204, October 22nd: $214, after October 22nd: $240
Registration Policy
Please register as follows: 1. Complete the online registration form, including the online waiver with an electronic signature 2. Give the Deposit money to the church you are attending with, made out to that church. 3. By each registration deadline (Oct. 21, Nov 1, Nov 8) the church must send ONE check from the church made out to "GA NYI" to secure the registration price. 4. Please send payment to: Mt. Olive Church of the Nazarene ATTN: Nannette Mayo 591 Mt. Olive Church Rd. Wrightsville, GA 31096. PLEASE NOTE: your registration is not finalized until your church has mailed in a check for the deposit for the participants. Registration costs are based on the POST MARKED date of the check sent from your church. All late fees are FINAL due to the increased cost from the campgrounds.
The Rules:
- NO weapons, drugs, tobacco, vape products, alcohol, fireworks,- Be respectful of other people and property- Modest clothing at all times- No one is allowed out of their cabin after curfew. No male students are allowed in the female dorms and no female students are allowed in the male dorms. We are requesting all chaperones to please be diligent to keep an eye out for your students at all times during the retreat as well as alerting other youth leaders to potential issues with their students. If there any questions about behavior or rules please direct them to your event leaders.
Need Help?
If you need any help registering, or have any questions about the process, please contact our team at georgiafallretreat@gmail.com, and you will receive an answer within 24 hours.
GA NYI Fall Retreat - Adult Registration
Use this form to register adult sponsor/chaperone for the Georgia NYI Fall Retreat.
Adult Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Home Phone
*
Please enter a valid phone number.
Gender
*
Please Select
Male
Female
T-Shirt Size (Adult)
*
Please Select
Small
Medium
Large
X-Large
2X-Large
3X-Large
Church you are attending with
*
Medical and Insurance Information
Please provide as much detail as possible when completing allergies and medical needs. Please know that we will NOT be collecting medications, and that each church will be responsible for making arrangements with a responsible adult leader to oversee the distribution of prescription medication. We will have a Camp Nurse available for minor injuries and non-prescription medication distribution as necessary (e.g. antacids, Tylenol, Benadryl, etc.)
Date of Last Tetanus Shot (an approximation is acceptable)*
*
-
Month
-
Day
Year
Date
Does you have any medical needs or allergies?*
*
Yes
No
If yes to the above, please describe:
Insurance Company
*
Policy #
*
Is there any other information that would assist the Retreat Director and Nurse?
Emergency Contact
In the event of either a medical emergency or a failure to abide by the expectations and Camper Covenant, we need the best emergency contact.
Full Name
*
Relationship to adult
*
Cell Number
*
Additional Phone Number
Comments:
General and Medical Release
Please read the following General and Medical Release statements and complete the electronic signature below.
Damage Release
I/We further accept responsibility for my actions and agree to be financially liable for any damages resulting from unacceptable behavior.
Medical Release
If it is necessary for me to receive medical, surgical, or dental care administered, I/we give permission for the trip leader to authorize care for me for the period of the activity as a part of the event.
Signature (type first and last name)*
*
The last four (4) digits of your SSN#*
*
Todays Date
*
Adult Covenant
The participating Adult must read and sign the following statement:
The Adult Covenant
I understand that this is retreat is a unique opportunity to have fun, build relationships, and encounter God. I will respect the rule, the adult leaders, the property, and the safety of everyone in attendance. I commit to fully participating and making this the best event for me as I am able to. I understand that failure to respect the rules, persons, or property could result in me being required to leave the event early at the expense of my family. But I know that wouldn’t be a problem!
Signature of Adult (First and last name)
*
Todays Date
*
-
Month
-
Day
Year
Date
Congratulations!
You've completed the Online Registration Form for your student. Your next step is: 1. Send your deposit monies to the church you are attending with. 2. Remind your NYI Director or Pastor to send ONE church from your church to lock-in your registration cost
Your Email Address
*
What's next?
You will receive a confirmation email from nmayo@dublinmedicalcenter.com with reminders and packing instructions. This email address will be used to send a follow-up reminder the week of the Fall Retreat.
Submit
Should be Empty: