Winter Retreat 2023 Staff Registration
December 30th-January 1st 2022/2023 @ Camp Rock Creek.
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Email *
Your Name *
Age *
Emergency Contact - Name, Number, and Email *
Where do you go to church? *
Are you a baptized Christian? (For Communion Prep) *
Hoodie Size? (not applicable after 12/13) *
Dietary restrictions *
How will you be paying? *
Insurance Disclaimer: By submitting this form, the participant (or parent/guardian) acknowledges and accepts the risks of physical injury associated with participation in the activity described above, except for gross negligence on the part of the sponsor. The participant (or parent/guardian) accepts personal financial responsibility for any bodily or personal injury sustained during the activity. Further, the participant (or parent/guardian) promises to hold harmless the sponsoring organization and its representatives for any injury related to the activity. Do you agree? *
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