Lock-In Registration
Please complete the following survey to register for the Grace Community Christian Church Summer Lock-In! Registration closes at 11:59 pm on Sunday, August 1st. Please email any questions, comments, or concerns to Assata Gilmore at gilmorea@purdue.edu.
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Name (First, Last) *
Age *
Please list any food allergies you have below (Write N/A for none): *
Is any special care, medication or diet required? (If yes, please email requirements to gilmorea@purdue.edu) *
What is your favorite candy?
What is your favorite beverage?
What is your favorite song?
PARTICIPANT CODE OF CONDUCT: (To be signed by participant.)By signing this, I agree to behave in a respectful and appropriate manner during the entire event. If I do not behave appropriately and follow the directions/rules of the retreat leader(s) I understand that my parent(s)/guardian(s) will be notified. I may also be sent home early and prohibited from attending Grace youth events and trips in the future. (To sign please type your full name below) *
Parent/Guardian Name: *
Parent/Guardian Phone Number: *
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