2026 Diocesan Women and Teen Girls Retreat Registration

2026 Diocesan Women and Teen Girls Retreat Registration

Camp Shiloh, 753 Burnt Meadow Road, Hewitt, NJ
Retreat Accommodations (Women Only):

This is a women-only retreat for teen girls and adult women. Lodging is in the lodge at Camp Shiloh with shared, bunk-style rooms, with teens and adults housed in separate rooms. Because space is limited, bottom bunks are reserved only for those who cannot sleep on a top bunk. Please indicate on the form if you require a bottom bunk so we can prioritize accordingly.
Attendee Information

Please fill out a separate form for each participant. There is NO fee to attend!
Participant information:*

Youth Participant (Ages 14-17)Adult Participant (18+)
Who will be transporting your minor? (ie: John Smith, father)*
Do you require a bottom bunk?*
Participant's Full Name*

First NameLast Name
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email Address*
Cell Phone Number
Please enter a valid phone number.
Date of Birth*

MonthDayYear
Date
Age*
Age Range*
Grade in School*
Parent Name*

First NameLast Name
Parent Email*
example@example.com
Parent Cell Phone Number*
Please enter a valid phone number.
Which diocese are you from? If outside of the OCA, please review the "Other" options and choose your jurisdiction.*
Parish (name, city, and state)*
If you do not attend a parish in the OCA Diocese of New York & New Jersey, please share your Parish information in the following format: Saint John the Baptist, Little Falls, NJ*
example: Saint John the Baptist, Little Falls, NJ
OCA Diocese of New York & New Jersey Media Release Form

Sign ONLY IF if you agree with the below.
I hereby authorize and consent to the use of my/my child’s visual image by the Orthodox Church in America (OCA), the Diocese of New York & New Jersey, and the OCA’s Diocese of New York & New Jersey Department of Youth Ministry for appropriate purposes, including but not limited to: still photography, video, electronic and print publications, the OCA’s Diocese of New York & New Jersey Department of Youth Ministry social media pages on Facebook, Instagram, YouTube, and websites.

In witness whereof, I give this consent with no claim for payment by digitally signing my name below:
Parent/Legal Guardian's Signature

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2026 Diocesan Women and Teen Girls Retreat Registration

Retreat Accommodations (Women Only):

Attendee Information

OCA Diocese of New York & New Jersey Media Release Form