JR. HIGH LOCK-IN REGISTRATION 2023
WHEN/WHERE IS THE JR. HIGH LOCK-IN?
The Jr. High Lock-In will take place March 24-25, beginning at the Lighthouse. Registration will begin at 8:30 on March 25th. The Lock-In will end at 7:00am on Saturday, March 26th.

WHAT DO I NEED TO BRING?
Students should wear warm and active clothes for the night. Students may also want to bring a pillow and blanket/sleeping bag for a nap during the night.

HOW MUCH IS THE LOCK-IN?
The cost for the Lock-In will be $40.00. This money will cover the cost of activities, meals, a t-shirt/hoodie, and any necessary transportation.


HOW DO I SIGN UP?
To attend the Sr. High Retreat, complete the registration form below and submit your money by no later than WEDNESDAY, MARCH 16th. Checks should be made to the Centerville Church of Christ.


**DISCLAIMER**
Our retreat involves various games and activities which could present a risk of injury or illness. I/We the  parent/s or guardian/s of the student mentioned, a minor, do acknowledge such risks and release Centerville Church of Christ and its staff/volunteers from liability. I/We also hereby authorize Centerville Church of Christ staff/volunteers to consent to any examination, treatment, and hospital care that is deemed advisable by a physician in the exercise of their best judgment and release them from liability. I/We also understand the inherent risks involved with our child participating in activities at and during the Jr. High Retreat which can cause exposure to the coronavirus and COVID-19, and do hereby release the Centerville Church of Christ from all liability.




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Student's Name (First & Last) *
Student Phone Number
Student or Parent Email Address (We will send an email with more info.) *
Student's Grade *
Date of Birth *
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DD
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Shirt Size (Adult Sizes) *
Parent/Guardian Name *
Parent/Guardian Phone Number: *
Do you have any allergies or medical conditions we should know about?
Are you taking any medications?
Please list your insurance provider.
Has a parent or guardian read and agreed to the Sr. High Retreat disclaimer?
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