JUNIOR HIGH SPRING RETREAT
Illinois and Wisconsin District
Church of the Brethren
Junior High Spring Retreat
at Camp Emmaus
April 24-25
Please Complete for each attendee.
Name_____________________________________ adult or youth
Date of Birth_________________________Gender M or F
Grade in 2008-2009 school year 5th 6th 7th 8th 9th
Address_____________________________________________
Phone ______________________________________________
Your email__________________________________________
Home Church _______________________________________
Registration fee for this event is $15.00 includes activities and meals.
Parents we may leave the retreat site for activities. Please sign giving permission for your youth to be taken to these activities. Drivers will be at least 21 years of age and have a valid drivers license.
Parent’s signature____________________________________________________
Emergency contact numbers____________________________________________
Your Physician____________________________ phone number______________
Allergies?________________________________________________________
Current Medications _______________________________________________
If your youth needs meds please indicate details on medicine bottle.
Physical limitations________________________________________________
In the event of emergency I give permission for retreat leaders to take my youth to Doctor or hospital. I agree that the Doctor may treat my child in emergency.
Parent ____________________________________________date____________
Jr. High Retreat invites any youth 5th through 9th grade to come together for a few hours of discovery at Camp Emmaus. We will spend the weekend discovery the beauty and wonder of creation. Please arrive after supper and we will begin our time together about 7:00 depending on when most people have arrived. There will be time to worship together, play games together and renew friendships.
Please bring Clothes for the weather we will be at camp and will be doing some outdoor activities. If weather permits we will even have a campfire so don’t forget a sweat shirt and hiking shoes. Remember it’s April not July camp is much cooler this time of year. The retreat lodge has beds but you’ll need to bring bedding including a pillow.
Registration can be sent to Lisa or if you prefer bring it with you. If you are bringing your registration information with you please send Lisa an Email that says you are coming. If the registration fee is a problem please let one of us know a few scholarships are available. Please note please make checks payable to Lisa Fike.
Church of the Brethren
Junior High Spring Retreat
at Camp Emmaus
April 24-25
Please Complete for each attendee.
Name_____________________________________ adult or youth
Date of Birth_________________________Gender M or F
Grade in 2008-2009 school year 5th 6th 7th 8th 9th
Address_____________________________________________
Phone ______________________________________________
Your email__________________________________________
Home Church _______________________________________
Registration fee for this event is $15.00 includes activities and meals.
Parents we may leave the retreat site for activities. Please sign giving permission for your youth to be taken to these activities. Drivers will be at least 21 years of age and have a valid drivers license.
Parent’s signature____________________________________________________
Emergency contact numbers____________________________________________
Your Physician____________________________ phone number______________
Allergies?________________________________________________________
Current Medications _______________________________________________
If your youth needs meds please indicate details on medicine bottle.
Physical limitations________________________________________________
In the event of emergency I give permission for retreat leaders to take my youth to Doctor or hospital. I agree that the Doctor may treat my child in emergency.
Parent ____________________________________________date____________
Jr. High Retreat invites any youth 5th through 9th grade to come together for a few hours of discovery at Camp Emmaus. We will spend the weekend discovery the beauty and wonder of creation. Please arrive after supper and we will begin our time together about 7:00 depending on when most people have arrived. There will be time to worship together, play games together and renew friendships.
Please bring Clothes for the weather we will be at camp and will be doing some outdoor activities. If weather permits we will even have a campfire so don’t forget a sweat shirt and hiking shoes. Remember it’s April not July camp is much cooler this time of year. The retreat lodge has beds but you’ll need to bring bedding including a pillow.
Registration can be sent to Lisa or if you prefer bring it with you. If you are bringing your registration information with you please send Lisa an Email that says you are coming. If the registration fee is a problem please let one of us know a few scholarships are available. Please note please make checks payable to Lisa Fike.
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