Elevate Winter Retreat 2020

Elevate Youth Winter Retreat 2020

Puyallup Nazarene Church
The youth (7th-12th) at Puyallup Nazarene Church are headed to Double K Retreat Center in Easton, Washington on February 21st through February 23rd. The cost is $125. This covers everything they need from dinner Friday through breakfast Sunday. If they would like to purchase snacks and/or beverages throughout the weekend, have your student bring extra cash. This form will require a $50 deposit. All monies are due by Wednesday, February 5th in the form of cash or check made out to PNC.

If you have any questions, e-mail Pastor Jared Trygg at jtrygg@pnconline.org.
Student First Name *
Student Last Name *
Student Gender *
Example: Male or Female
Student Birthday *

Month Day Year
Date Date Picker Icon
Student E-mail (If applicable)
example@example.com
Student Phone Number (If applicable)

Area Code Phone Number
Student Grade *
Student School *
Example Puyallup High School
Student T-Shirt Size *
All Sizes are Adult Sizes
Student Sweatshirt Size *
All Sizes are Adult Sizes
Parent/Guardian Name *

First Name Last Name
Parent/Guardian E-mail *
example@example.com
Parent/Guardian Phone Number *

Area Code Phone Number
Electronic Signature: please note that submitting your names below signifies your acknowledgement of the above information as well as signifies your electronic signatures here for the below listed names.
Student Electronic Signature *
Parent/Guardian Electronic Signature *
Payment
Winter Retreat costs $125 per person. $50 due with online registration and $75 due by Wednesday, February 5th in the form of cash or check made out to PNC.

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Deposit Due At Registration $ 50.00

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Total $ 0.00

Payment Method

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Should be Empty:

Elevate Youth Winter Retreat 2020

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