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2019 Preteen Retreat
November 8-10, 2019 @ Shiloh Park for 4th - 6th Graders
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Email
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Your email
Camper's Name
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Gender
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Female
Male
Church Name
*
Your answer
Church Phone Number
*
Your answer
Church Mailing Address
*
Your answer
Church E-mail Address
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Your answer
District
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Northeast Indiana
Northwest Indiana
Indianapolis
Other:
Parent / Guardian Name(s)
*
Your answer
Parent / Guardian Phone
*
Your answer
Grade
*
4th
5th
6th
Allergies
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Camper's Special Needs, Medical Conditions, or Diagnosis
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Please enter your child’s Mailing Address ONLY if you give permission for your child’s counselor to be given this contact information:
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