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Youth Retreat Winter 2026

Student Name *

Student Grade *

common.choose

Parent/Guardian Name *

Parent/Guardian email *

Parent/Guardian Phone Number *

Does student have any allergies/medical conditions that we need to be aware of? *

My student needs at ride: *

nope- no ride needed!

to the retreat on Friday

home from the retreat Friday night

to the retreat on Saturday morning

home from the retreat on Saturday night

to the retreat Sunday morning

home from the retreat Sunday afternoon

Pickup Addres for Ride

My student will be attending: *

Friday

Saturday

Sunday