Youth Winter Retreat 2026

January 2nd - January 4th | Please fill this out if you are going on the youth group winter retreat! Must have sign ups and money and forms by December 15th!

January 2nd- January 4th

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Name

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Email

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This address will receive a confirmation email

Phone

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Address

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Does your child have any food allergies that we need to be aware of? I will reach out to discuss if so!

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Please select all that apply.

Yes No

Are you planning on coming as a chaperone?

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Please select one option.

Yes No Undecided

How many students are coming?

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Please select one option.

1 2 3 4 Unsure yet

What is your student's (and chaperone's) t-shirt size

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What is a worship song you would like to sing at the winter retreat?

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Payment

$150 is full payment, but if siblings come then it’s $75 for the first 2 and the 3rd sibling for free. Also $75 off for you and a friend if you bring someone who is not from our youth group. Please discuss with Mikayla if you have questions about payment! If you are able and willing to pay full price, it would really assist others who might need scholarships to be able to go!

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Payment

Full price ($150) Discounted ($75) Other (as discussed with Mikayla

Amount

Credit/Debit Card Number

Expiration Date/CVC

Name on Card

Card Billing Address

Description

January 2nd - January 4th

Please fill this out if you are going on the youth group winter retreat! Must have sign ups and money and forms by December 15th!

Please Fix the Following

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