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Youth Retreat Registration Forms
This form
must
be completed by the parent or guardian of the camper.
Please complete one form for each camper.
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* Indicates required question
Registration Type
*
Youth
Adult Chaperone
Retreat Director
Who is filling out this form on behalf of the camper?
*
Parent
Legal Guardian
Camper's Legal Name
*
Your answer
Camper's Preferred Name
Your answer
Camper's Birthday
*
MM
/
DD
/
YYYY
Camper's Sex
*
Male
Female
Camper's Gender Identity
Male
Female
Non-Binary
Other:
Clear selection
Camper's preferred pronouns
she/her
he/him
they/them
Other:
Clear selection
Camper's Mailing Address
*
Your answer
Camper's Email Address
Your answer
Camper's grade level this fall:
*
Choose
6th
7th
8th
9th
10th
11th
12th
High School Grad
Adult
Please list any dietary needs/restrictions or food allergies here:
Your answer
Camper's T-shirt Size
*
Choose
Youth S
Youth M
Youth L
XS
S
M
L
XL
XXL
XXXL
Home Church
*
Your answer
Home Church City & State
*
Your answer
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