Back to School Retreat (B2SR) Registration Form

Student Info

Student Name

Student Grade Level (as of Fall 2022)

Student Cell Phone Number

Student T-Shirt Size

Does your student have any allergies or dietary restrictions? If yes, please describe.

Parent Info

Parent/Guardian Name

Parent/Guardian Email Address

This address will receive a confirmation email

Parent/Guardian Cell Phone Number

Address

B2SR Payment $75

Payment Policy: This retreat registration form and $70 payment are due by Wednesday, July 27, 2022. Payments must be submitted online through the secure retreat registration form. If you are unable to submit the total payment by July 27th, please contact Faith East to make arrangements. Need-based scholarships are available (please contact Faith East for more information).

Attendance: Students who attend the retreat are asked to stay for the entirety of the weekend. If for some reason you are unable to attend the entire weekend, arrangements must be made with the Student Pastor in-advance (before the retreat begins). B2SR will conclude after Sunday morning worship at 11:30am. Please contact Faith East if you have any questions.

Liability/Consent Statement: All parents (or students age 18 years or older) will be required to have a signed and completed retreat waivers/health forms on file before attending Back to School Retreat. Your decision to attend represents your agreement that CUMC's protocols are reasonably protective measures taken by CUMC for the protection of our students and congregation.

I have read and agree to both the Payment Policy & Liability/Consent Statement.

Yes

Let's go to B2SR! (:

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Back to School Retreat (B2SR) Registration Form | Summer/Fall 2022

Description

Back to School Retreat (B2SR) Registration Form | Summer/Fall 2022

Description

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