Youth Spring Retreat Registration Form

Youth Spring Retreat Registration Form

Register for the Youth Spring Retreat (March 19-22, 2026). Please complete all required fields below.
Participant Full Name*

First NameLast Name
Participant Age*
Participant Grade*
Participant Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Participants T-Shirt Size-Guaranteed tshirt if registered by 3/1/26
If registering after 3/1, there is no guarantee of tshirt. Sorry
Any Allergies or Medical conditions? Medications? Explain briefly in box below.
Gluten FreeDairy FreeVegetarianNoneOther
Will drive themselvesWill need a rideParent driving them up
Parent/Guardian Full Name*

First NameLast Name
Parent/Guardian Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email Address*
example@example.com
YesNo
If you answered Yes to having medical insurance, please provide the insurance company name: Insurance Company Name.
If you answered Yes to having medical insurance, please provide the policy number: Policy Number.
Parent/Guardian Signature*
Follow these instructions carefully...

1. Click "Register" below to complete your registration. 2. Go back to the original youth page to find the payment link to submit $60 for the retreat. If you would consider helping us with processing fees, please add $2 to your final amount. Thank you!

3.Contact Kelsie 541-507-7029 to pay for the retreat by check or cash. Thank you!
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