Clone of Youth Retreat Registration Form Camp Nakamun 2024

Youth Retreat Registration

Youth Retreat - February 13-15, 2026 at Camp Nakamun. The early bird cost to attend is $180 until January 31st and $190 from February 1st to February 8th. Camp is Friday at 6:00 pm until Sunday at 2:00 pm. This year only bring 1 piece of luggage and 1 backpack. Please see Pastor Josh if cost is an issue. Please note we have a cap of 160 students this year because of limited space.
Parent/Guardian Name*

First NameLast Name
Parent/Guardian Phone Number*

Area CodePhone Number
Parent/Guardian E-mail*
How many Youth are you registering?*
Youth #1
Youth's Name*

First NameLast Name
I have completed a Youth Information Form for 2025/2026This is REQUIRED*
In order to attend youth retreat, a 'Youth Information Form' MUST be filled out. If you have not filled it out yet, please visit http://www.sgac.net/youthinformationalform to access and complete the form!
Gender*
Grade*
T-Shirt Size
One person I would like on the bus and in my cabin

First NameLast Name
I recognize I can only bring 1 piece of luggage and 1 backpack*

Yes
Allergies (if none, write "none") indicate which child*
I will be bringing the following medications to camp with me.
In case of sickness, such as headaches, cramps or allergies I give permission for my child to be administered a dose of the following basic medications:
Youth #2
Youth's Name

First NameLast Name
I have completed a Youth Information Form for 2025/2026 This is REQUIRED
In order to attend youth retreat, a 'Youth Information Form' MUST be filled out. If you have not filled it out yet, please visit http://www.sgac.net/youthinformationalform to access and complete the form!
Gender
Grade
T-Shirt Size
One person I would like on the bus and in my cabin

First NameLast Name
I recognize I can only bring 1 piece of luggage and 1 backpack

Yes
Allergies (if none, write "none") indicate which child
I will be bringing the following medications to camp with me.
In case of sickness, such as headaches, cramps or allergies I give permission for my child to be administered a dose of the following basic medications:
Youth #3
Youth's Name

First NameLast Name
I have completed a Youth Information Form for 2025/2026 This is REQUIRED
In order to attend youth retreat, a 'Youth Information Form' MUST be filled out. If you have not filled it out yet, please visit http://www.sgac.net/youthinformationalform to access and complete the form!
Gender
Grade
T-Shirt Size
One person I would like on the bus and in my cabin

First NameLast Name
I recognize I can only bring 1 piece of luggage and 1 backpack

Yes
Allergies (if none, write "none") indicate which child
I will be bringing the following medications to camp with me .
In case of sickness, such as headaches, cramps or allergies I give permission for my child to be administered a dose of the following basic medications:
Youth #4
Youth's Name

First NameLast Name
I have completed a Youth Information Form for 2025/2026 This is REQUIRED
In order to attend youth retreat, a 'Youth Information Form' MUST be filled out. If you have not filled it out yet, please visit http://www.sgac.net/youthinformationalform to access and complete the form!
Allergies (if none, write "none") indicate which child
Gender
Grade
T-Shirt Size
One person I would like on the bus and in my cabin

First NameLast Name
I recognize I can only bring 1 piece of luggage and 1 backpack

Yes
I will be bringing the following medications to camp with me.
In case of sickness, such as headaches, cramps or allergies I give permission for my child to be administered a dose of the following basic medications:
Youth #5
Youth's Name

First NameLast Name
I have completed a Youth Information Form for 2025/2026 This is REQUIRED
In order to attend youth retreat, a 'Youth Information Form' MUST be filled out. If you have not filled it out yet, please visit http://www.sgac.net/youthinformationalform to access and complete the form!
Allergies (if none, write "none") indicate which child
Gender
Grade
T-Shirt Size
One person I would like on the bus and in my cabin

First NameLast Name
I recognize I can only bring 1 piece of luggage and 1 backpack

Yes
I will be bringing the following medications to camp with me.
In case of sickness, such as headaches, cramps or allergies I give permission for my child to be administered a dose of the following basic medications:
Any additional comments
Contract of Conduct

*I am coming to this retreat to have a great time; I realize there are rules that I must follow.

*I will refrain from inappropriate language and/or behavior. This includes but is not limited to: foul language, possession or use of illegal drugs, tobacco, alcohol, energy drinks, treating others disrespectfully, bullying, inappropriate public displays of affection towards others, etc.

*I will dress modestly, including my bathing suit.

*I will not use a portable music or game system, or be glued to my cellphone; I will make myself available to interact with others.

*I will not, at any time, enter the sleeping quarters of the opposite sex. I will be sent home at my or my parent's expense.

*I will not, at any time, be alone with a member of the opposite sex. The breaking of this rule will mean that I will be sent home immediately at my or my Parents' expense.

*I will not, at any time, leave the premises of Camp Nakamun without the consent of my Parent(s) AND Pastor Josh.

*If I break or damage something, I am financially responsible to cover the expense.

*This retreat is a privilege, not a right, and I may be sent home if I violate any of these rules or expectations.
Youth #1 *

I accept the terms of the Contract of Conduct
Youth #2

I accept the terms of the Contract of Conduct
Youth #3

I accept the terms of the Contract of Conduct
Youth #4

I accept the terms of the Contract of Conduct
Youth #5

I accept the terms of the Contract of Conduct
Parent's/Guardian's Witness*

I have witnessed all the Youth listed above accepting the terms of the Contract of Conduct
Off-site/Overnight Permission

I/we hereby consent to the participation of my/our child/youth in this supervised off-site and overnight event. I/we understand that every precaution and adequate supervision is provided for this event.

While every precaution is taken for the safety and good health, some activities carry with them the inherent risk of personal injury beyond the risks associated with many of the recreational activities at SGAC. I/we understand and accept these risks and agree that by allowing our child/youth to participate in this activity, he/she may be taking part in a recreational activity that presents the potential for personal injury. I/we give permission for the supervisors of the event to provide any necessary medical treatment. I/we agree to indemnify and hold blameless SGAC, its board, staff and volunteers against any damage, loss, or injury suffered by my child/youth as a result of participation at this event.
Off-site/Overnight Permission*

I have read to and agree with the "Off-site & Overnight statement
Payment Type

I will pay onlineI will come into the office to pay by February 6I will pay on this form
Retreat Fee
prevnext( X )
Youth Retreat Registration$180.00CAD

Quantity OnlineQuantity In Office

Total $0.00CAD
Watch for an email with important information such as schedule and what to bring.
Should be Empty:

Youth Retreat Registration

Youth #1

Youth #2

Youth #3

Youth #4

Youth #5