New Life Youth Retreat 2025

New Life Youth Spring Retreat Form
Where: New Life Bible Church

Address: 2285 N. Hoisington Rd. Pecatonica, IL 61063

When: April 4-5

Who: Students 6th - 12th Grade

What:

The purpose of our Youth Spring Retreat is to get away with God! The goal is for the students to have a retreat experience away from the busyness of life to connect with God and eachother!

Our theme for this retreat is "All Eyes on You". We want to keep our eyes fixed on Jesus always! Hebrews 12:1-2 states, "Therefore, since we are surrounded by such a huge crowd of witnesses to the life of faith, let us strip off every weight that slows us down, especially the sin that so easily trips us up. And let us run with endurance the race God has set before us. 2 We do this by keeping our eyes on Jesus, the champion who initiates and perfects our faith. Because of the joy awaiting him, he endured the cross, disregarding its shame. Now he is seated in the place of honor beside God’s throne." We can so easily get disracted in life and get our eyes off of Jesus. This weekend our prayer and goal is for all of us to refocus on Jesus and apply this when we get back home!

There will be times of worship, teaching, Bible reading, team challenges and more!

Cost: $40

(If cost is an issue, please talk to Mia about possible scholarships)
Number of Students Attending
Name

First NameLast Name
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Student's Phone Number
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Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name

First NameLast Name
Date of Birth

MonthDayYear
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T-shirt Size

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example@example.com
Student's Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
T-shirt Size

SMLXL
Email
example@example.com
Student's Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
T-shirt Size

SMLXL
Email
example@example.com
Student's Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender

MaleFemale
T-shirt Size

SMLXL
Email
example@example.com
Phone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Friday, April 4th

Meet at NLBC: 5pm

Welcome: 5:30pm

Dinner: 6:30pm

Worship/Lesson Time: 7:15pm

Group Activity: 9pm

Lights out: 10:30pm

Saturday, April 5th

Breakfast: 8-8:30am

Personal Devotional Time: 8:30-9am

Worship/Lesson Time: 9-10am

Group Activites: 10-12pm

Lunch: 12-1pm

Worship/Lesson Time: 1-2pm

Group Activities: 2-5pm

Dinner: 5-5:30pm

Worship/Lesson: 5:45-6:45pm

Parent Pick-up at New Life: 7pm

**Schedule is an estimate and could change. Please be flexible!**

Consent for Medical Treatment

In the case of an emergency, parents will be contacted immediately.
I , as the team member or parent guardian so hereby authorize the Agent, acting as my agent, to consent to any x-ray, examination, anesthetic, medical, or surgical diagnosis, or treatment and hospital care or service, which is deemed advisable by and is rendered under the general or specific supervision of any licensed physician and surgeon, or the medical staff of a licensed hospital, whether such diagnosis or treatment is rendered at the office of said physician or at said hospital. It is understood that this authorization given in advance of any specific diagnosis, treatment or hospital care being rendered, but is given to provide authority and power on the part of the Agent to give specific consent to any/all diagnosis, treatment, or hospital care which the above mentioned physician, in the exercise of his/her best judgement, may deem advisable. I hereby waive and release New Life Bible Church, and/or Agent from damage, liability, claims, or causes of action arising from or relating to decisions made, consents granted, or authorizations made by an Agent pursuant to this Consent to Treatment.

Signature of parent guardian/team member:
First Name Last Name
Date of Birth:
Insurance Company:
Policy #:

Medical Information
Does the student have allergies including asthma?
Please explain on the field provided
Is the student currently under medication?
Please provide the details, the name of the medication and period of intake

Contact Information in Case of Emergency

For any questions or details please contact Mia Spickler: 469-733-2722 or Justin Spickler: 815-979-0382
Name

First NameLast Name
Phone Number:
Relation to student
Name

First NameLast Name
Phone Number:
Relation to student

What to Bring

We will have printed copies of this available.
-Paper Bible *can be provided by New Life*, Pen, Notebook will be provided.

-Overnight Clothes (please no spaghetti straps, crop tops, short shorts, etc.)

-Jacket/Sweatshirt

-Tennis shoes for activities

-Air mattress (We have cots available at the church)

-Pillow/blanket/sleeping-bag

-Toiletries (There will be no shower available)

-Prescription Medication (please keep in original package and fill out medication form. Place in zip-lock bag with student’s name clearly written on it)

What not to bring:

-We recommend not bringing tablets, laptops, smartwatches, etc. that could be lost or stolen--they are the student's responsibility. Students will not be able to use their phones during group time, devotionals, and meal-times, but can bring them.

-No knives, weapons, or anything that could be used as a weapon

-No fireworks

-No tobacco, drugs, or alcohol

-No complaining or bad attitudes!

Agreement and Expectations

Below is a basic overview of behavioral expectations for each student.
PURPOSE STATEMENT:

Our purpose is to grow in our love for God with all of our heart, soul, mind, and strength and to love our neighbors as ourselves in all we do!

We ask that during this trip, students exhibit:

-Godly Character

-A Servant Heart

-Integrity

-Flexibility

-Responsibility

-Puncutality/On-Time

-Respectful towards Leadership, fellow students, and any party involved.

-Positive Attitudes!

-Open Communication with Leadership of any problems or issues.
I blanks, as a participating student of New Life Youth, agree to and understand these expectations.
I give permission for my student to join New Life Youth of New Life Bible Church in any of the activities or trips sponsored by the Church, its staff and sponsors. I hereby release them from responsibility and liability for any illness or injury that my student may sustain during this activity. In the event of an emergency, I hereby authorize an adult leader of this activity as agent for me to consent to any X-Ray exam, medical, dental, or surgical diagnosis, treatment and hospital care advised and supervised by a physician, surgeon, dentist (as appropriate), licensed to practice under the laws of the state where services are rendered, either at a doctor’s office or in any hospital. I expect to be contacted as soon as possible.
Signature of Parent or Guardian

Clear
Should be Empty:

New Life Youth Spring Retreat Form

Consent for Medical Treatment

Medical Information

Contact Information in Case of Emergency

What to Bring

Agreement and Expectations