2019 Spring HS Retreat
AT EPIC | January 25-27 | 6pm Fri - 1pm Sun

COST: $60 per student.  Register by Wednesday, January 16

STEP 1: Please complete one registration form per student.

Please note: no refunds are available for this or any EPIC retreats. If circumstances require you to pull out after payment, we are happy to save your payment as credit for future EPIC events or retreats. Thank you for understanding!

YOUTH INFO
**used for communication and confirmation emails - check for typos**


ADDRESS


PARENT/GUARDIAN INFO
**used for communication and confirmation emails - check for typos**


YOUTH MEDICAL INFO

leave blank if none.


TIME AWAY
leave blank if none.


*PHOTO/VIDEO RELEASE

For privacy and safety, we will not publish names with photographs/videos.
I authorize the use/release of photographs and/or videos that include the INDIVIDUALS NAMED ABOVE for UCUMC use, in print and electronic materials (worship videos, e-mail blasts, church website, Facebook, etc.).



*RELEASE

Submitting this on-line form will be the equivalent of signing a paper registration form.

  • I have read and understand the above information. The information I have given EPIC is accurate and true to the best of my knowledge.
  • My electronic signature signifies my understanding that submitting this online form will be the equivalent of signing a paper registration form.

 

Due upon registration.


When this form is processed, you will receive a confirmation email with payment instructions. Thank you!