Register — Youth Retreat 26 | Scicon Camp Oct 23-25

1

Camper info

Camper full name

Age

Ages 12-19

Date of birth

Grade

Gender

Shirt size

Church / youth group

2

Parent / guardian

Parent/guardian name

Relationship

Phone

Email

Emergency contact name

Emergency contact phone

3

Health & care

Allergies

Medications

Anything else we should know

4

Consent & deposit

How did you hear about the retreat?

Deposit method

Paid in person to a leader.

As the parent/guardian I give permission for my camper to attend Youth Retreat 26 at Scicon Camp Oct 23-25, authorize emergency medical treatment if needed, and agree that my camper will follow the retreat code of conduct and leaders' instructions.

Signature (type parent/guardian full name)

Register for Youth Retreat 26

Camper details

Camper info

Parent / guardian

Health & care

Consent & deposit