Fall Retreat Registration
When: October 28th-30th

Where: YMCA Blue Ridge Assembly

How much: $125

Don't let money be an issue, we have you covered! Let us know if you need help paying for the weekend
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Participant's Name *
first and last name of student or chaperone registering to go
What grade is participant in? (adult chaperones choose adult chaperone option) *
Phone Number (Student/Chaperone) *
Parent's Phone Number: (Chaperone's Put NA) *
Parent Email (Chaperone's Put Your Email Address) *
Participant's Shirt Size: *
Activity! (Choose your Favorite Option) *
Activity! (Choose your Second Favorite Option) *
Activity! (Choose your Least Favorite Option) *
Late Bus (Football Players, Cheerleaders, Band Members, etc.) *
Any food allergies or dietary needs *
Please list any medical conditions we need to be aware of: *
How do you want to pay? *
Any questions or concerns
Contact Jackson:

jackson@thomsonfumc.org

(706) 831-7287
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