Fall Retreat 2019 Chaperone Registration
This form is for Adult Chaperone Registration only!

We appreciate our adults who volunteer their time to go on our trips and love on our students.  Because of this there is no event cost for our Parent Adult Chaperones, although donations are accepted if you wish to do so!  For our Non-parent and College Adult Chaperones, we offer a discounted price of $15.00.

Thank you for being Jesus to our students and showing them the way of Christ.
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Which church are you attending Fall Retreat with? *
Required
Begin Online Registration
Chaperone Full Name *
Last name, First name
Chaperone Email Address *
Valid Email
Chaperone Phone Number *
Valid Number
Chaperone Full Address *
Current Full Address
T-Shirt Size *
If we work it out to get T-Shirts for this event, what size would you prefer?
Required
Adult Volunteer [18+] Background Check Form Required
We require a Background Check on all Adult Volunteers [18+] who are attending an overnight trip with us. If we don't have one on file for you, please contact us through the Office, at either Fairlane or Southside.
Additional Information
Is there any other information you'd like us to know that wasn't included in this registration process?
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