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Winter Retreat Registration Form

Winter Retreat Registration Form

January 23rd-25th, 2026
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    "PLANS"

    Winter Retreat 2026 at Camp Maranatha

    *Event Ages: 6th-12th Grade

    *Event Address: 19870 W Camp Drive, Wasilla, AK 99623  (Camp Maranatha)

    *Event Check-In: 7:00pm-8pm Friday January 23rd, 2026 (there is no dinner on Friday but there will be a snack later in the night)       

    *Event ends at 11:30am on Sunday, January 25th. (there is no lunch on Sunday)

    Here are a few items that your student should bring:

    • Bible, journal, and pen
    • Winter coat/ attire for outdoor activities, gloves
    • Ice cleats (if desired)
    • Pillow, sleeping bag and/or blankets 
    • Appropriate sleeping attire
    • Personal toiletries, shower items, towel, change of clothes for Saturday and Sunday
    • Money for the snack shack (if desired)

     

    *Any student that transports themselves will be required to turn their keys in upon check-in. 

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    Student Information

    A single form should be filled out for each student!

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    • Small
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    We will do our best to accommodate preferences, but cannot guarantee them!
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    Parent/Guardian Information

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    Emergency Information

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    • Mother
    • Father
    • Grandparent
    • Aunt
    • Uncle
    • Sibling
    • Guardian
    • Other
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    • My child needs NO special considerations during this activity
    • My child has the following special needs or considerations related to this activity
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    Type N/A if you selected no
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    If no, type N/A
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    Please check if a designated leader is allowed to give to your student.
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    Medical Release and Authorization

    In the event of a medical emergency, if I cannot be contacted, I hereby give permission to the church staff, chaperones, trip leaders, and authorized drivers in cooperation with Alaska District NYI and Camp Maranatha to provide necessary medical treatment for my child. In the event of an emergency, if I, as well as the secondary emergency contact cannot be contacted, I hereby give permission to medical personnel to administer necessary medical treatment including hospitalization for my child. I will be responsible for the expense of any such emergency medical procedures or treatment.

    I hereby release and waive all claims against Camp Maranatha, Alaska District Church of the Nazarene, their employees, representatives, volunteers, drivers, and chaperones related to this event.


    This form has been signed only after understanding and considering all of the information set forth above.

     

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    Informed Consent and Acknowledgement

    In the signing of this document, I state that I am the parent/legal guardian of this student and I hereby authorize and give my permission for my student to participate in Winter Retreat 2026. I understand that volunteer staff, chaperones, and trip leaders will supervise my child at this event. 

    In addition to this, all students are expected to respect each other and all adult leaders and abide by any rules set forth at this event. Failure to do so may result in removal from the event. There will be no refunds for this event once the payment has been made. All payments are due by check-in.  

    All students are expected to remain at the event the entire time and will be required to turn in their keys if they drive themselves. Any arrangements in which a student needs to leave, show up late or get picked up early must be communicated at least a week prior to the event. If there are any time restraints or conflicts that will coincide with this event please state the details in the special considerations portion of this form.

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    BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
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    Payment Information

    *There is a link on the confirmation page to pay online! It will ask if you'd like to make a donation to keep the app free, please do not feel obliged to do so! Simply click other and set the donation amount to zero. You can also pay by check! Please make checks payable to Alaska District NYI. Please ensure that all payments are designated to Winter Retreat with your student(s) name.

    *Early Bird registration is $110; After January 2nd registration is $130. Final day to register is Janaury 23rd! All payments are due upon check-in on January 23rd. 

    *If you have questions, contact Andrew Sheets at pastorandrew@hillcrestnaz.com or (402) 710-1608!

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