Event Registration

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Winter Retreat 2024 - Middle School on Friday, February 23, 2024 @ 4:00 PM

Price:

279.00

*Attendee's First Name:

*Attendee's Last Name:

*Attendee's Email Address:

*Attendee's Phone Number:

Country:

Address Line 1:

Address Line 2:

City, State Zip:

Additional Information

*Student grade:

*Gender:

Male Female

*Birthdate:

*School:

*Campus my student attends weekly:

Parent/Guardian's Information

*Who does the student live with?:

Primary Parent/Guardian

*First Name 1:

*Last Name 1:

*Cell Number 1:

*Email 1:

Secondary Parent/Guardian

First Name 2:

Last Name 2:

Cell Number 2:

Email 2:

Student may also be release to the person(s) listed below:

Contact 1: (Name/Phone):

Contact 2: (Name/Phone):

Contact 3: (Name/Phone):

Go to 12Stone.com/winterretreat for a packing list, the required Student Ministry Participation Release form, and more information about Winter Retreat.

Parent Meetings will be held at each campus on Sunday, February 4th following the last Sunday worship service. All students are required to have a notarized Parent Participation Release form on file to attend Winter Retreat. Notaries will be available after all parent meetings to help with Parent Participation Release form.

I HAVE READ THIS DOCUMENT AND UNDERSTAND THAT ALL REGISTRATION PAYMENTS ARE NON-REFUNDABLE

*Digital Signature

Promo Code:

Registration Total: