Youth Retreat Registration

Unlikely Superheros

Youth Retreat Registration

Unlikely Superheroes

July 22 - 26, 2024 from 10:00 AM - 12:00 PM

Free, if registered. Lunch is provided.

Parent Information
* Denotes a required field

First Name

Last Name

Mailing Address*

Address

Apartment, suite, etc.

City

State

Zip/Postal Code

Mobile Phone

Photo Release
I give Monument Community Presbyterian Church (MCPC) the right to use any images, videos, or comments of my son/daughter/ward for publicity purposes related directly to the mission of Monument Community Presbyterian Church (MCPC)

I Agree

Yes

I give permission for my student to check-in/out on their own

Yes

Will you be coming in to sign your student in and out?

Yes

Will someone else be picking up your student?

Yes

>>> If someone else is picking up your student, please state who is authorized to do so.

Individual authorized to pick up your student

Anyone NOT authorized to pick up your student

Attendee

First Name

Last Name

Birthdate

Grade*

Choose....

Allergies

Medical needs

Special notes

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Youth Retreat Registration

Unlikely Superheros

Youth Retreat Registration

Unlikely Superheroes

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Hearing Loop in our Sanctuary

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