Young Adult Retreat 2022
June 29-July 2
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Email *
An option to print your registration is also available. Please click the link below and mail the completed form to: PO Box 10195, Cleveland, OH 44110. Be sure to sign the form as well.
https://drive.google.com/file/d/16rULtdA4o2aAY27dIrWy3xqT_YIfM6zv/view?usp=sharing
Full Name *
Age *
Gender *
Home Church/Pastor *
10:00AM-11:00AM Classes (Pick the one you are interested in attending)
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1:30PM-2:30PM Classes (Pick the one you are interested in attending)
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2:30PM-3:30PM Classes (Pick the one you are interested in attending)
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How will you pay? *
Required
How much are you paying today? *
A $10 deposit is due by May 29th to avoid a late fee.
Allergies (if none, say "N/A") *
Will you be interested in purchasing a camp t-shirt? *
Dress code Agreement - Women- Shorts (to the knee), pants, skirts (to the knee), no tank tops, no leggings. On the water day- must have a shirt and shorts covering undergarments. Men- shorts (to the knee), pants, no tank tops. By clicking "I agree," you are stating that you will follow the camp dress code. If you select "disagree" we will deny your registration. *
Liability Agreement - By checking the "I agree" box below, you are in agreement that Church of God Mountain Assembly/Camgroundhills is not liable for any lost/stolen items. You are in understanding that there are certain dangers, hazards and risks (foreseen and unforeseen) inherent in attending and participating in the Campgroundhills, including, without limitation, risks related to use of equipment and  facilities, personal safety (including risks of minor, serious or mortal personal injury) and risks of property damage.  If you disagree to the stated above, we will deny your registration. *
By submitting this form you are agreeing that you have read and understand all of the information included with this form.  You are also stating that you are authorized to provide the above information/consent and that all the information provided is current and correct to the best of your knowledge.
A copy of your responses will be emailed to the address you provided.
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