* Stuck in the Middle…..Now What?

Registration Form              Deadline: February 21, 2006

 

Name of Adult Contact____________________________________ 

 

e-mail _____________________________ Phone ________________

 

Church_______________________________Town _____________________   

 

Adult attending __________________________________________________  M or F

 

Adult attending ___________________________________________________M or F

 

Text Box: Total # Adults
________
 
Total # Youth ________
 
 
Total registration fee included  
 
­­_____________
 
(@ $35.00 each)

 

Name of Youth                                               M or F

 

         

___________________________________________________________

 

__________________________________________________________

 

___________________________________________________________

 

___________________________________________________________

 

___________________________________________________________

 

___________________________________________________________

 

___________________________________________________________

 

___________________________________________________________

 

___________________________________________________________

 

Large groups may attach an additional sheet.

 

Please go over the following covenant with your youth.  You may want to write it up on newsprint and have them sign it.  Thank you for your support and participation.

 

I have chosen to participate in the Middle School Retreat at Camp Kirkwood.  As a member of the Christian community that will gather there, I promise God and the community that I will participate fully in all scheduled activities and to seek help for others and myself if any problems arise. I promise to respect others’ property and to honor others through my attitudes and actions. I promise to abide by the curfew and other guidelines of the hosting facilities, to abstain from using or possessing controlled substances and to remain on the camp property throughout the retreat.  Pictures of participants may be used on the Presbytery Web Site unless you request differently.

 
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