Journey Retreat Registration 2025

JOURNEY RETREAT 2025

FRIDAY, NOVEMBER 21 — SUNDAY, NOVEMBER 23
STUDENT INFORMATION
Student Name*

First NameLast Name
Student Cell Phone Number*

Area CodePhone Number
Student Gender*
Student Grade*
For 2025-2026 School Year
Student T-shirt Size*
Student Pant Size*
Student Shoe Size*
Friend Requests — Please write down 1-3 student names

PARENT/GUARDIAN INFORMATION
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Email Address*
yac@yacherd.com
Parent Guardian Phone Number*

Area CodePhone Number
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

FREE TIME ACTIVITY
Students will have a chance to participate in one of the following free time activities during the retreat. The activities to choose from are bazooka ball (like paintball but inside and with foam balls), paintball, high ropes course, or just hanging out. Each student will get to do one activity.

Please let us know below which activity your student would like to do. We cannot guarantee that your student will be able to do their first choice activity, but we will do our best!
1st Free Time Activity Choice*

Bazooka BallPaintballHigh Ropes CourseI'm fine to just hang out during free time!
2nd Free Time Activity Choice*

Bazooka BallPaintballHigh Ropes CourseI'm fine to just hang out during free time!

Medical Information
Did your student attend any of the following YAC events in 2025? If so, please select one event that your student attended

Confirmation Retreat 2025Discovery Weekend 2025Summer Trip 2025 (Sr. High Lake Trip 2025, Six Flags Getaway 2025, Jr. High Adventure Trip 2025, Magic City Work Week 2025, Sr. High Rafting Getaway 2025, Braves Game Getaway 2025)Unfortunately, my student missed these 2025 trips!
Has your student's health insurance or medical information changed since the last 2025 YAC trip your student attended?

Yes, my student's health insurance and/or medical information has changedNo, my student's health insurance and medical information is the same
Yay! Since you've already filled out a medical form & your student's health information is the same, you don't need to fill out another one for the Journey Retreat! With our new medical information system, you are not required to fill out another Medical Information Form until 2026. We can't wait to spend the weekend with your student on the Journey Retreat!

Click the "Submit" button below to go to the Journey Retreat 2025 Payment Page!
Since your student's health information has changed, we'll need a new medical form.

Please click the "Submit" button below to go to the Medical Information Form. Make sure to have your health care provider information handy.
Our Medical Information Forms are collected annually. After filling out the medical information once in 2025, you will not have to fill it out again until 2026!

Please click the "Submit" button below to go to the Medical Information Form. Make sure to have your health care provider information handy.
Should be Empty:

JOURNEY RETREAT 2025

STUDENT INFORMATION

PARENT/GUARDIAN INFORMATION

FREE TIME ACTIVITY

Medical Information